Factors Associated With Coronary Angiography Performed Within 6 Months of Randomization to the Conservative Strategy in the ISCHEMIA Trial

Radosław Pracoń*, John A. Spertus, Samuel Broderick, Sripal Bangalore, Frank W. Rockhold, Witold Ruzyllo, Elena Demchenko, Thuraia Nageh, Gabriel Blacher Grossman, Kreton Mavromatis, Cholenahally N. Manjunath, Paola E.P. Smanio, Gregg W. Stone, G. B.John Mancini, William E. Boden, Jonathan D. Newman, Harmony R. Reynolds, Judith S. Hochman, David J. Maron, William E. BodenKreton Mavromatis, John Doan, Jason Linefsky, Raven Lee, Risha Patel, Todd Miller, So Yang Cho, Susan Milbrandt, Dawn Shelstad, Subhash Banerjee, Preeti Kamath, Ishita Tejani, Harmony R. Reynolds, Jonathan D. Newman, Sripal Bangalore, Robert M. Donnino, Lawrence M. Phillips, Muhamed Saric, Khaled Abdul-Nour, Allison Schley, Heather Golden, Peter H. Stone, Hermine Osseni, Charlene Wiyarand, Peter Douglass, Hayley Pomeroy, Alexandra Craft, Bethany Harvey, James J. Jang, Olivia Anaya, Gennie Yee, Phoebe Goold, Steven Weitz, Steven Giovannone, Lori Pritchard, Suzanne Arnold, Rosann Gans, James Henry O'Keefe, Paul Kennedy, Michael D. Shapiro, Shobana Ganesan, David Schlichting, Aynun Naher, Steven A. Fein, Wendy L. Stewart, Mikhail T. Torosoff, Kristin M. Salmi, Radmila Lyubarova, Sulagna Mookherjee, Krzysztof Drzymalski, Edward O. McFalls, Santiago A. Garcia, Stefan C. Bertog, Debra K. Johnson, Rizwan A. Siddiqui, Rebekah R. Herrmann, Areef Ishani, Ronnell A. Hansen, Michel Georges Khouri, Kristine Arges, Melissa LeFevre, Jennifer Tomfohr, Jonathan L. Goldberg, Kimberly Ann Byrne, Taissa Zappernick, Richard Goldweit, Sallie Canada, Meghana Kakade, Patricia Mieses, Ronny A. Cohen, Brooks Mirrer, Victor Navarro, Magdalena Rantinella, Jessica Rodriguez, Olivia Mancilla, David E. Winchester, Susan Stinson, Marvin Kronenberg, Terry Weyand, Philip Rogal, Sherron C. Crook, Christopher McFarren, John F. Heitner, Jean Ho, Saadat Khan, Mahmoud Mohamed, Ira M. Dauber, Mary R. Soltau, Delsa K. Rose, Rebecca J. Wimmer, Kathy E. Siegel, Susan Derbyshire, Charles Cannan, Michelle Dixon, Gerald Leonard, Sriram Sudarshan, Ciarra Heard, Viviana Gabriel, Sukie Desire, Puja K. Mehta, Michael McDaniel, Fauzia Rashid, Stamatios Lerakis, Senait Asier, Arshed Quyyumi, Keyur Patel, Nanette K. Wenger, Chester M. Hedgepeth, Jennifer Gillis, Heather Hurlburt, Megan Manocchia, Alan Rosen, Susan Moore, Elizabeth Congdon, Zakir Sahul, Gail Brandt, Nora Marchelletta, Kristina Wippler, David Booth, Yvonne Taul, Steve Leung, Jennifer Isaacs, Ahmed Abdel-Latif, Viktoria Bulkley, Hassan Reda, Caroline Rodgers, Khaled Ziada, Sampoornima Setty, Kimberly E. Halverson, Christine Roraff, Jonean Thorsen, Rajat S. Barua, Amarachi Ojajuni, Oni Olurinde, Kamalakar Surineni, Fadi Hage, Badhma Valaiyapathi, Christiano Caldeira, James E. Davies, Massoud Leesar, Jaekyeong Heo, Amy Iskandrian, Firas Al Solaiman, Satinder Singh, Khaled Dajani, Carol M. Kartje, Mohammad El-Hajjar, Paul Der Mesropian, Joseph Sacco, Michele Rawlins, Brian McCandless, Jennifer Thomson, Marisa Orgera, Mandeep S. Sidhu, Mary Colleen Rogge, Imran Arif, Julie Bunke, Hanan Kerr, Kendra Unterbrink, Jacqueline Fannon, Cynthia Burman, Jorge F. Trejo, Marcia F. Dubin, Gerald Fletcher, Gary E. Lane, Lynn M. Neeson, Pragnesh P. Parikh, Peter M. Pollak, Brian P. Shapiro, Kevin Landolfo, Anthony Gemignani, Sarah Beaudry, Daniel O'Rourke, Judith L. Meadows, Stephanie A. Tirado, Janet Halliday, Pamela Julian, Jason T. Call, Stephanie M. Lane, Jennifer L. Stanford, Joseph Hannan, Robert Bojar, Patricia Arsenault, Deepti Kumar, Pamela Sigel, John Mukai, Edward T. Martin, Miriam Brooks, Gabriel Vorobiof, Ladda Douangvila, Rubine Gevorgyan, Alec Moor-Man, Fatima Ranjbaran, Bryn Smith, Carly Ohmart, Scott Kinlay, Robert J. Hamburger, Thomas P. Rocco, Samantha Ly, Deepak L. Bhatt, Margot C. Quinn, Kevin Croce, Sara Temiyasathit, Jacquelyn A. Quin, Jacquelyn Do, Jati Anumpa, Desiree Tobin, Marco Zenati, David P. Faxon, Glenn Rayos, Jennifer Langdon, Marcia Werner Bayer, Ashraf Seedhom, Amanda O'Malley, Lance Sullenberger, Erin Orvis, Gregory Kumkumian, Mandy Murphy, Ann Greenberg, Margaret Iraola, Steven P. Sedlis, Leandro C. Maranan, Robert M. Donnino, Jeffrey Lorin, Jacqueline E. Tamis-Holland, Ammy Malinay, Robert Kornberg, Robert Leber, Souheil Saba, Candice P. Edillo, Michael W. Lee, Delano R. Small, Wassim Nona, Patrick B. Alexander, Iram Rehman, Umesh Badami, Ann Ostrander, Stephanie Wasmiller, Kevin Marzo, Wendy Drewes, Dipti Patel, Inga H. Robbins, Howard A. Levite, Jackie M. White, Sanjay Shetty, Alison Hallam, Mayuri Patel, Glenn S. Hamroff, Benjamin J. Spooner, Linda M. Hollenweger, Raymond W. Little, Holly Little, Brandi D. Zimbelman, Tiffany Little, Charles Y. Lui, Nona A. Eskelson, Brigham R. Smith, Daniel P. Vezina, Lillian L. Khor, Josephine D. Abraham, David A. Bull, Stephen H. McKellar, David Booth, Yvonne Taul, John Kotter, Caroline Rodgers, Ahmed Abdel-Latif, Jennifer Isaacs, Viktoria Bulkley, Bob Hu, Renee Kaneshiro, Arthur J. Labovitz, Michael Berlowitz, Bonnie J. Kirby, Philip Rogal, Nhi N. Tran, Christopher McFarren, Catherine Jahrsdorfer, Fadi Matar, Christiano Caldeira, David J. Maron, Fatima Rodriguez, Reem Yunis, Ingela Schnittger, Jhina Patro, William F. Fearon, Prakash Deedwania, Antonia Vega, Kiran Reddy, Joseph Sweeny, Hugo Bloise-Adames, Santa Jimenez, Nicole Saint Vrestil, Reyna Bhandari, Christopher Spizzieri, Danielle Schade, Roxanne Yost, Claudia P. Hochberg, Paula Beardsley, Denise Fine, William D. Salerno, Jana Tancredi, Patricia Arakelian, Susan Mathus, Deborah O'Neill, Ray Wyman, Joy Burkhardt, Suellen Hosino, Oksana A. Lubyanaya, Jose D. Salas, Amer Zarka, Maria Aguirre, Anil V. Shah, Manu Dhawan, Diana Parra, Tri Tran, Thomas Haldis, Catherine Weick, Katie Fowler-Lehman, Natalie Spitzer, Casey Riedberger, Catherine Weick, Jeffrey A. Kohn, Stanley E. Cobos, Kirsten J. Quiles, Saket Girotra, Carrie Drum, Kimberly Miller-Cox, Amy Ollinger, Omar Almousalli, Elizabeth Capasso-Gulve, Alaine Melanie Loehr, Marlowe Mosley, Mayil S. Krishnam, Shirin Heydari, Jeffrey C. Mil-Liken, Andrea M. Lundeen, Pranav M. Patel, Edgar Karanjah, Arnold H. Seto, Wanda C. Marfori, Kevin T. Harley, Eduardo Hernandez-Rangel, Michael A. Gibson, Pam Singh, Byron J. Allen, Rita Coram, Anne Marie Webb, Ellie Fridell, Heidi Wilson, Sabu Thomas, Angela Kim, Ronald G. Schwartz, Patrick Wilmot, Wei Chen, Mahfouz El Shahawy, Ramona Stevens, James Stafford, Loriane Black, William B. Abernethy, Amber B. Hull, Olivia J. Lim, Helen C. Tucker, Natasha C. Putnam, Linda L. Hall, Tia Cauthren, Trish Tucker, Andrew Zurick, Hollie Horton, Jan Orga, Thomas M. Meyer, Joyce R. White, Ronald G. Morford, Cynthia Baumann, Bruce Rutkin, Vidya Seeratan, Sabahat Bokhari, Magnolia Jimenez, Seth I. Sokol, Cidney Schultz, Jay Meisner, Jeanne Russo, Ihab Hamzeh, Arunima Misra, Zohra Huda, Matthew Wall, Araceli Boan, Veronica Lenges De Rosen, Mahboob Alam, Michael C. Turner, Christine R. Hinton, Thomas J. Mulhearn, Arnold P. Good, Beth A. Archer, Julia S. Dionne, Cheryl A. Allardyce, Lindsey N. Sikora, Jennifer H. Czerniak, Jennifer A. Mull, Elizabeth Ferguson, Frances Laube, Nicolas W. Shammas, Gail A. Shammas, Lori Christensen, Holly Park, Robert Chilton, Joan Hecht, Patricia K. Nguyen, Davis Vo, James Hirsch, Matthew Jezior, Jody Bindeman, Sara Salkind, Dalisa Espinosa, Lori Ann Desimone, Paul C. Gordon, Lina Felix-Stern, Thomas Crain, Jassira Gomes, Catherine Gordon, Robert Stenberg, Aimee Mann, Theresa McCreary, Ronald P. Pedalino, Stanley E. Cobos, Raven R. Dwyer, Dalisa Espinosa, Kirsten J. Quiles, Joseph Wiesel, George J. Juang, Candace Gopaul, Karen Hultberg, Tauqir Huk, Afshan Hussain, Mohammed Al-Amoodi, Yesenia Zambrano, Sarah Medina Rodriguez, Trudie Milner, David Wohns, Abbey Mulder, Stacie Van Oosterhout, Ellis W. Lader, Martha Meyer, Michael Mumma, Nancy L. Clapp, Heather Barrentine, Lekshmi Dharmarajan, Jenne M. Jose, Jenne Manchery, Joseph F.X. McGarvey, Vera McKinney, Linda Schwarz, Thomas R. Downes, Scott M. Kaczkowski, Gary J. Luckasen, Adam J. Jaskowiak, Joel Klitch, Benjamin Cheong, Debra Dees, Srinivasa Potluri, Precilia Vasquez, Ronald A. Mastouri, Jeffery A. Breall, Elise L. Hannemann, George E. Revtyak, Judy Mae Foltz, Jonathan W. Bazeley, Dayuan Li, Emily DeRosa, Beth Jorgenson, Joyce Riestenberg-Smith, Kenneth Giedd, Wayne Old, Rebecca Bariciano, Francis Burt, Kozhaya Sokhon, Jessica Waldron, Michelle Mayon, Deepika Gopal, Uma S. Valeti, Gretchen Ann Peichel, Jon Kobashigawa, Brandy Starks, Lucilla Garcia, Maria Thottam, Balram Bhargava, Anjali Anand, Sajeev Chakanalil Govindan, Janitha Raj, Rajesh Gopalan Nair, Reshma Ravindran, V. S. Rajalekshmi, Cholenahally Nanjappa Manjunath, Nandita Nataraj, Nagaraja Moorthy, Soundarya Nayak, Satvic Cholenahally Manjunath, Mahevamma Mylarappa, Suryaprakash Narayanappa, Neeraj Pandit, Sheromani Bajaj, Ranjit Kumar Nath, Vandana Yadav, Girish Mishra, S. K. Dwivedi, Roma Tewari, V. S. Narain, Meenakshi Mishra, Sharad Chandra, Shivali Patel, Suman Singh, Gurpreet S. Wander, Rohit Tandon, Sarju Ralhan, Baljeet Kaur, Naved Aslam, Sonika Gupta, B. Pharmacy, Abhishek Goyal, Balram Bhargava, Chandini Suvarna, G. Karthikeyan, S. Ramakrishnan, Sandeep Seth, Rakesh Yadav, Sandeep Singh, Ambuj Roy, Neeraj Parakh, Sunil Kumar Verma, Rajiv Narang, Sundeep Mishra, Nitish Naik, Gautam Sharma, Shiv Kumar Choudhary, Chetan Patel, Gurpreet Gulati, Sanjeev Sharma, V. K. Bahl, Anoop Mathew, Binoy Mannekkattukudy Kurian, Eapen Punnoose, Milind Avdhoot Gadkari, Sheetal Rupesh Karwa, Siddharth Gadage, Suvarna Kolhe, Tapan Umesh Pillay, Santhosh Satheesh, R. J. Vindhya, Peeyush Jain, Ashok Seth, Zile Singh Meharwal, Atul Mathur, Atul Verma, Upendra Kaul, Mona Bhatia, Ankush Sachdeva, Thounaojam Indira Devi, Nungshi Jungla, Johann Christopher, K. Manjula Rani, Rajeev Menon, M. Sowjanya Reddy, Nirmal Kumar, K. Preethi, Abraham Oomman, Rinu R. Sidh, Robert Mao, T. Ramakrishnan, Hilda Solomon, Rajesh Francis, Sudhir Naik, Vamshi P. Priya, Sajeeda Parveen Khan, Johann Christopher, Kotiboinna Preethi, Nirmal Kumar, Purvez Grant, Shweta Hande, Poonam Sonawane, Ranjan Kachru, Abhishek Dubey, Kavita Rawat, Ajit V.K. Kumar, Sanjay Ganapathi, K. Jayakumar, C. P. Vineeth, Harikrishnan Sivadasanpillai, Manas Chacko, Bijulal Sasidharan, Suresh Babu, T. R. Kapilamoorthy, Johann Christopher, Sowjanya Reddy, Praneeth Polamuri, Manjula Rani, Upendra Kaul, Priyadarshani Arambam, Bebek Singh, Roxy Senior, Keith A.A. Fox, Grace M. Young, Kathryn Carruthers, Ahmed Elghamaz, Sothinathan Gurunathan, Nikolaos Karogiannis, Grace M. Young, Benoy N. Shah, Christopher Kinsey, Richard H.J. Trimlett, Raisa Kavalakkat, Michael B. Rubens, Jo Evans, Edward D. Nicol, Ikraam Hassan, Tarun K. Mittal, Reinette Hampson, Reto Andreas Gamma, Sarah Williams, Kim Holland, Karen Swan, Mark A. de Belder, Bev Atkinson, Jeet Thambyrajah, Thuraia Nageh, Swapna Kunhunny, John R. Davies, Steven J. Lindsay, Craig Atkinson, John Kurian, Carita Krannila, Haqeel Jamil, Manitha Vinod, Osama Raheem, Angela Hoye, Lisa Chaytor, Leanne Cox, Julie Morrow, Kay Rowe, Patrick Donnelly, Stephanie Kelly, Bernardas Valecka, Susan Regan, Dawn Turnbull, Anoop Chauhan, Catherine Fleming, Arijit Ghosh, Karen Gratrix, Stephen Preston, Craig Barr, Anne Cartwright, Khaled Alfakih, Abigail Knighton, Jonathan Byrne, Katherine Martin, Ian Webb, Peter Henriksen, Laura Flint, James Harrison, Peter OKane, Nicki Lake-Man, Anja Ljubez, Ramesh de Silva, Dwayne S.G. Conway, Judith Wright, Donna Exley, Alexander A. Sirker, Mervyn Andiapen, Amy J. Richards, Stephen P. Hoole, Lisa Wong, Fraser N. Witherow, Melanie J. Munro, Nicola Johnston, Bch Bao, Mark Harbinson, Bch Bao, Michelle McEvoy, Simon Walsh, Bch Bao, Caroline Brown, Hanna Douglas, Matthew Luckie, Thabitha Charles, Laurel Kolakaluri, Hannah Phillips, Jolanta Sobolewska, Louise Morby, Karen Hallett, Carolyn Corbett, Lynne Winstanley, Paramjit Jeetley, Angelique Smit, Niket Patel, Tushar Kotecha, Christopher Travill, Susan Gent, Iqbal Karimullah, Nafisa Hussain, Mahmud Al-Bustami, Denise Braganza, Fiona Haines, Joanne Taaffe, Robert Henderson, Jane Burton, Kate Pointon, Maria Colton, Surendra Naik, Rachel King, Thomas Mathew, Ammani Brown, Andrew Docherty, Colin Berry, Lisa McCloy, Damien Collison, Kate Robb, Giles Roditi, Craig Paterson, Wenda Crawford, Joanne Kelly, Lorraine McGregor, Andrew J. Moriarty, Anne Mackin, Jason D. Glover, Janet P. Knight, Jiwan Pradhan, Ghada Mikhail, Tuhina Bose, Darrel P. Francis, Vladimir Dzavik, Shaun Goodman, Gilbert Gosselin, Anna Proietti, Myriam Brousseau, Magalie Corfias, Patricia Blaise, Luc Harvey, Ariel Diaz, Philippe Rheault, Miguel Barrero, Carl Éric Gagné, Patricia Alarie, Yanek Pépin-Dubois, Linda Arcand, Ricardo Costa, Isabelle Roy, Ying Tung Sia, Estelle Montpetit, Catherine Lemay, Alejandro Gisbert, Pierre Gervais, Alain Rheault, Katia Drouin, Denis Carl Phaneuf, Christine Bergeron, Gilbert Gosselin, Christine Shelley, Christine Masson, Pallav Garg, Sandy Carr, Catherine Bone, Benjamin J.W. Chow, Ermina Moga, Renee C. Hessian, Janetta Kourzenkova, Rob S. Beanlands, Olga Walter, Richard F. Davies, Kevin R. Bainey, Norma Hogg, Suzanne Welsh, Asim N. Cheema, Akshay Bagai, Ron Wald, Shaun Goodman, Khrystyna Kushniriuk, John Joseph Graham, Mohammed Hussain, Mark Peterson, Olugbenga Bello, Chi Ming Chow, Beth Abramson, Asim Nazir Cheema, Ishba Syed, Mohammad Tariq Vakani, Mohammed Hussain, Khrystyna Kushniriuk, James Cha, Judy Otis, Rebecca Otis, Andrew G. Howarth, Michelle M. Seib, Sandra M. Rivest, Rosa Sandonato, Graham Wong, Jackie Chow, Andrew Starovoytov, Naomi Uchida, Ngaire Meadows, Amar Uxa, Nadia Asif, Suzana Tavares, Paul Galiwango, Bev Bozek, Saleem Kassam, Maria Shier, Ashok Mukherjee, Lori Ann Larmand, A. Joseph Ricci, Amir Janmohamed, Brenda Hart, Andy Lam, Jane Marucci, Sharon Tai, Shamir Mehta, Sonya Brons, Chris Beck, Glenda Wong, Krystal Etherington, Thippeekaa Arumairajah, Jacob Udell, Maria Aprile, Sara Karlsson, Susan Webber, Philippe Généreux, Chantale Mercure, Adnan Hameed, Nancy Aedy, Ledjalem Daba, Fran Farquharson, Anam Siddiqui, Antonio Carlos Carvalho, Renato D. Lopes, Whady Hueb, Myrthes Emy Takiuti, Paulo Cury Rezende, Expedito Eustáquio Ribeiro Silva, Alexandre Ciappina Hueb, Paola Emanuela Poggio Smanio, Leonardo Pizzol Caetano, Alexandre Schaan de Quadros, Renato Abdala Karam Kalil, Aline Peixoto Deiro, José Luiz da Costa Vieira, Alice Manica Muller, Gabriel Grossmann, Maria Antonieta Pereira de Moraes, Pedro Píccaro de Oliveira, Bruna Maria Ascoli, Leonardo Bridi, Sílvia Zottis Poletti, Simone Savaris, João V. Vitola, Rodrigo J. Cerci, Sandra S. Zier, Fabio R. Farias, Vilmar Veiga, Miguel M. Fernandes, José Antonio Marin-Neto, André Schmidt, Moysés de Oliveira Lima Filho, Diego Franca da Cunha, Ricardo Mendes Oliveira, João Reynaldo Abbud Chierice, Carísi A. Polanczyk, Guilherme G. Rucatti, Mariana V. Furtado, Fernanda Igansi, Luis F. Smidt, Mauren P. Haeffner, Antonio Carlos Carvalho, Viviane Almeida, Gustavo Pucci, Gabriela Sanchez de Souza, Flavio Lyra, Alvaro Rabelo Alves, Mayana Almeida, Viviane dos Santos, Marianna D.A. Dracoulakis, Natalia S. Oliveira, Rodolfo G.S.D. Lima, Estevao Figueiredo, Bruna Edilena Paulino Azevedo, Paulo Ricardo Caramori, Marco Bizzaro Santos, Amanda Germann, Vitor Gomes, Rosa Homem, Ellen Magedanz, Rogerio Tumelero, Rosane Laimer, Alexandre Tognon, Frederico Dall'Orto, Claudio T. Mesquita, Roberta P. Santos, Alexandre S. Colafranseschi, Amarino C. Oliveira, Luiz A. Carvalho, Isabella C. Palazzo, Andre S. Sousa, Expedito Eustáquio Ribeiro da Silva, Pedro Gabriel Melo de Barros e Silva, Mariana Yumi Okada, Luciana de Pádua Silva Baptista, Ana Paula Batista, Marcelo Jamus Rodrigues, Aline Nogueira Rabaça, Marcos Valério Coimbra de Resende, Jose Francisco Saraiva, Larissa Miranda Trama, Talita Silva, Camila Thais de Souza Ormundo, Carla Vicente, Costantino Costantini, Caroline Pinheiro, Daniele Komar, Witold Ruzyllo, Hanna Szwed, Radoslaw Pracon, Marcin Demkow, Radoslaw Pracon, Cezary Kepka, Anna Teresinska, Olga Walesiak, Karolina Kryczka, Katarzyna Malinowska, Jan Henzel, Mateusz Solecki, Edyta Kaczmarska, Tomasz Mazurek, Jakub Maksym, Karolina Wojtera, Anna Fojt, Ewa Szczerba, Jaroslaw Drozdz, Bartosz Czarniak, Malgorzata Frach, Konrad Szymczyk, Iwona Niedzwiecka, Sebastian Sobczak, Tomasz Ciurus, Piotr Jakubowski, Magdalena Misztal-Teodorczyk, Dawid Teodorczyk, Marta Swiderek, Aleksandra Fratczak, Ewelina Wojtala, Marcin Szkopiak, Patrycja Lebioda, Michal Wlodarczyk, Anna Plachcinska, Jacek Kusmierek, Magdalena Miller, Halina Marciniak, Karolina Wojtczak-Soska, Katarzyna Łuczak, Tomasz Tarchalski, Anna Cichocka-Radwan, Hanna Szwed, Jaroslaw Karwowski, Grazyna Anna Szulczyk, Adam Witkowski, Krzysztof Kukuła, Małgorzta Celińska-Spodar, Joanna Zalewska, Grzegorz Gajos, Krzysztof Bury, Piotr Pruszczyk, Andrzej Łabyk, Marek Roik, Agnieszka Szramowska, Olga Zdończyk, Krystyna Łoboz-Grudzień, Joanna Jaroch, Leszek Sokalski, Barbara Brzezińska, Maciej Lesiak, Magdalena Łanocha, Krzysztof W. Reczuch, Adam Kolodziej, Zbigniew Kalarus, Andrzej Swiatkowski, Mariola Szulik, Wlodzimierz J. Musial, Marta Marcinkiewicz-Siemion, Olga Bockeria, Leo Bockeria, Karen Petrosyan, Zalina Kudzoeva, Tatiana Trifonova, Nodira Aripova, Alexander M. Chernyavskiy, Ivan A. Naryshkin, Evgeniy I. Kretov, Alena Kuleshova, Igor O. Grazhdankin, Dastan Malaev, Leonid L. Bershtein, Sergey A. Sayganov, Irina Subbotina, Anastasia M. Kuzmina-Krutetskaya, Victoria Gumerova, Elizaveta V. Zbyshevskaya, Nana O. Katamadze, Elena A. Demchenko, Olga B. Nikolaeva, Pavel S. Kozlov, Vikentiy Y. Kozulin, Ekaterina I. Lubinskaya, Jose Luis Lopez-Sendon, Almudena Castro, Jose Lopez-Sendon, Virginia Fernández-Figares, Almudena Castro, Elena Refoyo Salicio, Gabriela Guzman, Gabriel Galeote, Silvia Valbuena, Jesús Peteiro, María Dolores Martínez-Ruíz, Ruth Pérez-Fernández, Moisés Blanco-Calvo, José J. Cuenca-Castillo, Encarnación Alonso-Álvarez, Xacobe Flores-Ríos, Paula García-González, Óscar Prada-Delgado, Gonzalo Barge-Caballero, Jose Ramon Gonzalez Juanatey, Jose Seijas Amigo, Miguel Souto Bayarri, Virginia Pubull Nuñez, Raymundo Ocaranza Sanchez, Belen Cid Alvarez, Carlos Peña Gil, Amparo Martinez Monzonis, Alessandro Sionis, Ana Fernández Martínez, Montserrat Vila Perales, Josep Maria Padró, Antonio Serra Peñaranda, Joan García Picart, Antonino Ginel Iglesias, Xavier Garcia Moll Marimon, Guillem Pons Lladó, Francesc Carreras Costa, Vicente Miro, Begoña Igual, Jose L. Diez, Pilar Calvillo, F. Marin Ortuño, M. Valdés Chávarri, M. Quintana Giner, A. Tello Montolliu, A. I.Romero Aniorte, E. Pinar Bermudez, J. M.Rivera Caravaca, G. De La Morena, Montserrat Gracida Blancas, Olga Cañavate, Sonia Guerrero, Silvia Riera, Jose Enrique Castillo Luena, Jose Enrique Castillo Luena, Maria Lasala, Francisco Fernandez-Aviles, Maria Lorenzo, Olga Sobrino, Alexandra Vazquez, Lixin Jiang, Jiyan Chen, Haojian Dong, Peiyu He, Chunli Xia, Junqing Yang, Qi Zhong, Yongjian Wu, Yanmeng Tian, Dongze Li, Yitong Ma, Xiaomei Li, Yining Yang, Xiang Ma, Zixiang Yu, Qian Zhao, Zheng Ji, Chunguang Li, Lei Zhang, Yu Zhao, Bolin Zhu, Xinchun Yang, Mulei Chen, Hongjie Chi, Yang Wang, Jing Zhang, Wenhua Lin, Rui Jing, Jingjing Liu, Hesong Zeng, Qiang Zhou, Chang Xu, Zhuxi Li, Junhua Li, Luyang Xiong, Xin Fu, Dan Gao, Dengke Jiang, Ran Leng, Xutong Wang, Qianqian Yuan, Lili Zhang, Bin Yang, Ziliang Bai, Jianhua Li, Jie Qi, Fei Wang, Haitao Wang, Bin Yang, Zhou Yue, Zhulin Zhang, Songtao Wang, Yumei Dong, Jiajia Mao, Bin Zhang, Gong Cheng, Xiuhong Li, Xiaowei Yao, Nier Zhong, Ning Zhou, Yulan Zhao, Yaping Huang, Panpan Zhou, Xuehua Fang, Wei Su, Qiutang Zeng, Yu Kunwu, Yudong Peng, Xin Su, Xi Su, Chen Wang, Yunhai Zhao, Qingxian Li, Yaming Geng, Yanfu Wang, Shao Ping Nie, Jing Yao Fan, Si Ting Feng, Xiao Wang, Yan Yan, Hui Min Zhang, Qin Yu, Lingping Chi, Fang Liu, Jian'an Wang, Han Chen, Jun Jiang, Huajun Li, Jian'an Wang, Yechen Han, Lihong Xu, Shuyang Zhang, Zhenyu Liu, Zhenyu Liu, Gang Chen, Rongrong Hu, Aldo P. Maggioni, Gian Piero Perna, Francesca Pietrucci, Marco Marini, Gabriele Gabrielli, Stefano Provasoli, Anna Di Donato, Edoardo Verna, Lorenzo Monti, Barbara Nardi, Antonio Di Chiara, Francesca Pezzetta, Andrea Mortara, Valentina Casali, Marcello Galvani, Chiara Attanasio, Filippo Ottani, Marco Sicuro, Gianpiero Leone, Francesco Pisano, Cristina Bare, Paolo Calabro, Fabio Fimiani, Tiziana Formisano, Giuseppe Tarantini, Alberto Barioli, Umberto Cucchini, Federica Ramani, Anto Luigi Andres, Emanuela Racca, Fabrizio Rolfo, Cecilia Goletto, Carlo Briguori, Francesca De Micco, Roberto Amati, Stefano Di Marco, William Vergoni, Martina Tricoli, Aldo Russo, Massimo Villella, Raffaele Fanelli, Harvey Douglas White, Caroline Alsweiler, Kian Keong Poh, Ping Chai, Titus Lau, Joshua P. Loh, Edgar L. Tay, Kristine Teoh, Sik Yin V. Tan, Lynette L. Teo, Winnie C. Sia, Ching Ching Ong, Audrey W. Leong, Raymond C. 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Yeh, Ta Chuan Hung, Jiun Yi Li, Chen Yen Chien, Cheng Ting Tsai, Chun Chieh Liu, Fa Chang Yu, Yueh Hung Lin, Wei Ren Lan, Chih Hsuan Yen, Jui Peng Tsai, Kuo Tzu Sung, Mpiko Ntsekhe, Shaheen Pandie, Constance Philander, Charle A. Viljoen, Noloyiso Mtana, Marianne De Andrade, Aldo P. Maggioni, Tiziano Moccetti, Adriana Anesini, M. Grazia Rossi, Simona Maspoli, Manuela Mombelli, Magdy Abdelhamid, Ahmed Talaat, Ahmed Adel, Ahmed Kamal, Hossam Mahrous, Sameh El Kaffas, Hussien El Fishawy, Calin Pop, Matei Claudia, Bogdan A. Popescu, Carmen Ginghina, Monica Rosca, Dan Deleanu, Carmen C. Beladan, Vlad A. Iliescu, Mouaz H. Al-Mallah, Sarah Zahrani, Ahmed Aljzeeri, Hani Najm, Ali Alghamdi, Walter Enrique Mogrovejo Ramos, Marco Antonio Monsalve Davila, Srun Kuanprasert, Arintaya Prommintikul, Weerachai Nawarawong, Supatchara Khwakhong, Surin Woragidpoonpol, Anong Chaiyasri, Thitipong Tepsuwan, Warangkana Mekara, Noppon Taksaudom, Supap Kulthawong, Chataroon Rimsukcharoenchai, Anong Amaritakomol, Juntima Euathrongchit, Yutthaphan Wannasopha, Sukit Yamwong, Pachara Panpunuan, Piyamitr Sritara, Suthara Aramcharoen, Krissada Meemuk, Harvey Douglas White, Caroline Alsweiler, Ahmad Khairuddin, Noor Syamira Mokhtar, Hafidz Abd Hadi, Nor Asiah Basri, Shaiful Azmi Yahaya, Irni Yusnida, Humayrah Hashim, Raffaele Bugiardini

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

Abstract

BACKGROUND: ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) did not find an overall reduction in cardiovascular events with an initial invasive versus conservative management strategy in chronic coronary disease; however, there were conservative strategy participants who underwent invasive coronary angiography early postrandomization (within 6 months). Identifying factors associated with angiography in conservative strategy participants will inform clinical decision-making in patients with chronic coronary disease. METHODS: Factors independently associated with angiography performed within 6 months of randomization were identified using Fine and Gray proportional subdistribution hazard models, including demographics, region of randomization, medical history, risk factor control, symptoms, ischemia severity, coronary anatomy based on protocol-mandated coronary computed tomography angiography, and medication use. RESULTS: Among 2591 conservative strategy participants, angiography within 6 months of randomization occurred in 8.7% (4.7% for a suspected primary end point event, 1.6% for persistent symptoms, and 2.6% due to protocol nonadherence) and was associated with the following baseline characteristics: enrollment in Europe versus Asia (hazard ratio [HR], 1.81 [95% CI, 1.14-2.86]), daily and weekly versus no angina (HR, 5.97 [95% CI, 2.78-12.86] and 2.63 [95% CI, 1.51-4.58], respectively), poor to fair versus good to excellent health status (HR, 2.02 [95% CI, 1.23-3.32]) assessed with Seattle Angina Questionnaire, and new/more frequent angina prerandomization (HR, 1.80 [95% CI, 1.34-2.40]). Baseline low-density lipoprotein cholesterol <70 mg/dL was associated with a lower risk of angiography (HR, 0.65 [95% CI, 0.46-0.91) but not baseline ischemia severity nor the presence of multivessel or proximal left anterior descending artery stenosis >70% on coronary computed tomography angiography. CONCLUSIONS: Among ISCHEMIA participants randomized to the conservative strategy, angiography within 6 months of randomization was performed in <10% of patients. It was associated with frequent or increasing baseline angina and poor quality of life but not with objective markers of disease severity. Well-controlled baseline low-density lipoprotein cholesterol was associated with a reduced likelihood of angiography. These findings point to the importance of a comprehensive assessment of symptoms and a review of guideline-directed medical therapy goals when deciding the initial treatment strategy for chronic coronary disease. REGISTRATION: URL: https://www.clinicaltrials.gov; Unique identifier: NCT01471522. GRAPHIC ABSTRACT: A graphic abstract is available for this article.

Original languageEnglish
Pages (from-to)457-473
Number of pages17
JournalCirculation: Cardiovascular Interventions
Volume17
Issue number6
DOIs
StatePublished - 1 Jun 2024
Externally publishedYes

Keywords

  • angiography
  • coronary disease
  • ischemia
  • mortality
  • quality of life

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