As with our original ISCHEMIA (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) poll, this follow-up poll generated significant reader response, so this topic is clearly an attention getter. I appreciate your participation.

Interestingly, only 15% of respondents were unsure of the impact of the trial on practice because of "unclear" results; I believe this is a credit to the investigators. There was a nearly even split (40% vs. 43%) between the respondents as to the expected impact of the trial results on their practice, with nearly an equal number indicating they were already practicing within the scope of the results.

However, when challenged with a case of proximal left anterior descending artery (LAD) disease that, per the trial, would appear to be treated successfully with either medical therapy or percutaneous coronary intervention (PCI), slightly over two thirds of respondents chose revascularization as a preferred treatment strategy over medical therapy or CABG. This was an extreme example, but it suggests that despite agreement with the overall results of ISCHEMIA, clinicians still believe in the need to modulate treatment in special cases.

Thanks again to all who participated.

Keywords: Percutaneous Coronary Intervention, Follow-Up Studies, Coronary Vessels, Coronary Artery Bypass, Ischemia

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