Paul TK, Mamas MA, Shanmugasundaram M, et al. - By performing this review, researchers analyzed the evidence regarding optimal medical therapy (OMT) vs coronary revascularization in patients suffering from stable ischemic heart disease (SIHD) and advanced chronic kidney disease (CKD). In terms of cumulative incidence of death or nonfatal myocardial infarction (MI) at 3 years, no difference was identified between OMT and revascularization in the ISCHEMIA-CKD trial of 777 patients suffering from advanced CKD, but the invasive arm showed a higher composite of death or new dialysis. Overall, experts concluded that in patients with SIHD and advanced CKD, an initial revascularization strategy neither decreases mortality or MI and nor it relieves angina symptoms.