To address that very question, a team of researchers explored data from nearly 15,000 patients who participated in one of 14 randomized clinical trials. This covered more than 64,000 follow-up years altogether. Most of the included trials excluded patients with left main disease.
Death was the primary outcome of the meta-analysis, and cardiovascular dearth, myocardial infarction (MI), heart failure, stroke, unstable angina and freedom from angina were all secondary outcomes.
Overall, revascularization was not associated with a reduced risk of death when compared to GDMT alone. In addition, revascularization was linked to a decrease in non-procedural/spontaneous MI, an increase in procedural MI and “no difference” in overall MI.
Revascularization was also associated with a 36% decrease in unstable angina and a “modest” increase in freedom from angina.
“These observations should be used in shared decision-making discussions to determine the initial treatment approach in patients with SIHD,” the authors concluded.