Baseline predictors of LDL-cholesterol and systolic blood pressure goal attainment after one-year in the ISCHEMIA trial
In this analysis of 3,984 participants from ISCHEMIA (78% of 5179 randomized) with available data, predictors of reaching one-year goals are reported for low-density lipoprotein cholesterol (LDL-C) and systolic blood pressure (SBP). This paper was led by Jonathan Newman, M.D., M.P.H., from the New York University School of Medicine, and the ISCHEMIA trial investigators and is published today in Circulation: Cardiovascular Quality and Outcomes, an online-only, peer-reviewed journal of the American Heart Association dedicated to furthering the mission of promoting safe, effective, efficient, equitable, timely and patient-centered care.
It is known that risk factor control reduces events and improves survival for patients with stable ischemic heart disease (SIHD), however, it is often difficult to achieve. The ISCHEMIA authors found that levels of risk factor control at baseline, along with medication use and other demographic factors, predicted goal attainment at one year. Goal achievement was not analyzed by treatment group assignment, and final goal attainment was not reported.
The findings from this study of interim data from ISCHEMIA may inform researchers and clinicians regarding which patients are more or less likely to achieve risk factor control after one year using similar medical therapies and sets the stage for the presentation of ISCHEMIA results in the Late-Breaking Science 2 sessions at American Heart Association's Scientific Sessions 2019.
In an accompanying editorial, also published today in Circulation: Cardiovascular Quality and Outcomes, Rasha Al-Lamee, M.A. (Oxford), M.B.B.S., M.R.C.P.; Christopher Rajkumar, M.B.B.S., B.Sc., M.R.C.P.; and Michael Foley, Ph.D., from the Imperial College of London put these important findings from ISCHEMIA into perspective and discuss the critical role of baseline medical therapy in understanding trials of coronary revascularization.
Christopher A. Rajkumar et al. The Goldilocks Guide to Getting Medical Therapy 'Just Right', Circulation: Cardiovascular Quality and Outcomes (2019). DOI: 10.1161/CIRCOUTCOMES.119.006265