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Home › Conditions › myocardial ischemia

Myocardial ischemia

Subtypes of Myocardial ischemia

Coronary Artery Disease 130 Myocardial Infarction 57 ST-Segment Elevation Myocardial Infarction 13 ST-Elevation Myocardial Infarction 9 Angina 7 Cardiogenic Shock 6 Multivessel Coronary Artery Disease 6 Multivessel Disease 5 Coronary Atherosclerosis 4 Left main coronary artery disease 3 MINOCA 3 Non-ST-elevation myocardial infarction 3 Non-ST-segment elevation myocardial infarction 3 NSTEMI 2 Coronary Artery Stenosis 1 Left Main Disease 1 STEMI 1 Microvascular angina 0

215 published articles · Updated continuously

Clinical Trial Landscape

Clinical Trials for myocardial ischemia

58 trials tracked for myocardial ischemia: 15 in phase 3 or 4 and 2 with published results. The most-cited published study has 63 citations.

58Trials tracked
15Phase 3 & 4
0Recruiting
2With published results
Phase distribution
Phase 4 8 Phase 3 7 Phase 2 12 Other / NA 31
  1. Phase 4 ISCHEMIA-Chronic Kidney Disease Trial Completed · 63 cited
  2. Phase 3 Glutamate for Metabolic Intervention in Coronary Surgery Completed · 46 cited
  3. Phase 4 XIENCE V® USA Dual Antiplatelet Therapy (DAPT) Cohort Completed
  4. Phase 4 XIENCE V Everolimus Eluting Coronary Stent System (EECSS) China: Post-Approval Randomized Control Trial (RCT) Completed
  5. Phase 4 CES1 Carriers in the PAPI Study Completed
  6. Phase 4 Statin Therapy for Ischemic and Nonischemic Cardiomyopathy Completed
Show 44 more trials
  1. Phase 4 Effect of Ranolazine on Myocardial Perfusion Assessed by Serial Quantitative Exercise SPECT Imaging Completed
  2. Phase 4 Responses of Myocardial Ischemia to Escitalopram Treatment Completed
  3. Phase 4 XIENCE V: SPIRIT WOMEN Sub-study Completed
  4. Phase 3 SPIRIT PRIME Clinical Trial Completed
  5. Phase 3 METhotrexate Therapy Effects in the Physical Capacity of Patients With ISchemic Heart Failure (METIS Trial) Completed
  6. Phase 3 SPIRIT III Clinical Trial of the XIENCE V® Everolimus Eluting Coronary Stent System (EECSS) Completed
  7. Phase 3 An Efficacy and Safety Study for Rivaroxaban in Patients With Acute Coronary Syndrome Completed
  8. Phase 3 Women's Health Study (WHS): A Randomized Trial of Low-dose Aspirin and Vitamin E in the Primary Prevention of Cardiovascular Disease and Cancer Completed
  9. Phase 3 EARLY ACS: Early Glycoprotein IIb/IIIa Inhibition in Patients With Non-ST-segment Elevation Acute Coronary Syndrome (Study P03684AM2)(COMPLETED) Completed
  10. Phase 2 Safety of PZ-128 in Subjects Undergoing Non-Emergent Percutaneous Coronary Intervention Completed
  11. Phase 2 ACT34-CMI -- Adult Autologous CD34+ Cells Completed
  12. Phase 2 Evaluation of the Safety and Effectiveness of the CorPath 200 System in Percutaneous Coronary Interventions (PCI) Completed
  13. Phase 2 PK and Tolerability of IV and Oral CK-1827452 in Patients With Ischemic Cardiomyopathy and Angina Completed
  14. Phase 2 Trial to Assess the Safety and Effects of Vorapaxar in Japanese Subjects With Acute Coronary Syndrome (P04772; MK-5348-016) Completed
  15. Phase 2 Efficacy and Safety of Aliskiren and Valsartan Versus Placebo in Patients Stabilized Following an Acute Coronary Syndrome Completed
  16. Phase 2 The Effects of Intravenous Heme Arginate on Heme Oxygenase-1 Expression (HO-1) and Oxidative Stress in the Human Heart Completed
  17. Phase 2 Absolute Quantification of Coronary Flow Reserve by Stress Perfusion MRI Completed
  18. Phase 2 Custodiol-HTK (Histidine-tryptophan-ketoglutarate) Solution as a Cardioplegic Agent Completed
  19. Phase 2 Ranolazine Mediated PVC Reduction in Ischemic Heart Disease Completed
  20. Phase 2 Pilot Study of Atorvastatin for Orthopedic Surgery Patients Completed
  21. Phase 2 Microvascular Coronary Disease In Women: Impact Of Ranolazine Completed
  22. N/A A Clinical Evaluation of the XIENCE PRIME Small Vessel Everolimus Eluting Coronary Stent System in Japanese Population Completed
  23. N/A Stress CMR Perfusion Imaging in the United States (SPINS) Study Completed
  24. N/A AngioSculpt® Coronary Bifurcation Study Completed
  25. N/A ABSORB EXTEND Clinical Investigation Completed
  26. N/A XIENCE V Everolimus Eluting Coronary Stent System (EECSS) China: Post-Approval, Single-Arm Study Completed
  27. N/A Extracellular Matrix Marker of Arrhythmia Risk (EMMA) Completed
  28. N/A International Study of Comparative Health Effectiveness With Medical and Invasive Approaches (ISCHEMIA) Completed
  29. N/A Regadenoson Combined With Symptom-Limited Exercise in Patients Undergoing Myocardial Perfusion Imaging Completed
  30. N/A Scoreflex NC - Scoring PTCA Catheter Completed
  31. N/A Sapphire II PRO US Clinical Study Completed
  32. N/A Secondary Event Prevention Using Population Risk Management After PCI and for Anti-Rheumatic Medications Completed
  33. N/A Impact of a Corrie Cardiac Rehabilitation Program Completed
  34. N/A RESOLUTE Japan SVS: The Clinical Evaluation of the MDT-4107 DES in the Treatment of De Novo Lesions in Small Diameter Native Coronary Arteries Completed
  35. N/A XIENCE V/PROMUS Everolimus-Eluting Stent System Post-marketing Surveillance Protocol for Japan Completed
  36. N/A Pressure Guidewire System Multi-center, Prospective, Self-Control, Clinical Trial Completed
  37. N/A RESOLUTE Japan - The Clinical Evaluation of the MDT-4107 Drug-Eluting Coronary Stent Completed
  38. N/A XIENCE V® Everolimus Eluting Coronary Stent System USA Post-Approval Study (XIENCE V® USA Long Term Follow-up Cohort) Completed
  39. N/A AVJ-301 Clinical Trial: A Clinical Evaluation of AVJ-301 (Absorb™ BVS) in Japanese Population Completed
  40. N/A XIENCE PRIME SV Everolimus Eluting Coronary Stent Japan Post Marketing Surveillance (XIENCE PRIME SV Japan PMS) Completed
  41. N/A Data Analyses for Ancillary WISE Femhrt Hormone Replacement Study Completed
  42. N/A Absorb GT1 Japan PMS Completed
  43. N/A Safety and Effectiveness of the Orsiro Sirolimus Eluting Coronary Stent System in Subjects With Coronary Artery Lesions Completed
  44. N/A XIENCE PRIME Japan Post-Marketing Surveillance (PMS) Completed

Showing the 50 most-cited and recently-updated of 58 trials. Browse the full registry →

Trial data sourced from ClinicalTrials.gov. Counts describe the research landscape and are not a treatment recommendation. Informational only — not medical advice.

What the trials found For clinicians

Myocardial ischemia: what the trials found

Pharmacological management of myocardial ischemia includes various agents with distinct clinical profiles. Atorvastatin Calcium was associated with a significant increase in the percentage of Aldofluor Positive Cells (6.37% vs 5.7%, p<0.05) 2. Rivaroxaban 2.5 mg demonstrated a statistically significant reduction in the composite endpoint of cardiovascular death, myocardial infarction, or stroke (7.4% vs 6.1%; 6.1% vs 6.1%, p=0.020) and the composite of all-cause death, myocardial infarction, or stroke (7.5% vs 6.3%; 6.3% vs 6.3%, p=0.016) 10.

Interventional outcomes for coronary stents show varying results. The XIENCE V Everolimus Eluting Coronary Stent demonstrated significantly lower in-segment Late Loss (LL) (0.14% vs 0.28%, p<0.0001) and lower Ischemia Driven Target Vessel Failure (ID-TVF) (7.2% vs 9.0%, p<0.0001) 15. Other stent evaluations showed specific diameter stenosis measurements: XIENCE V EECSS reported in-stent percent diameter stenosis of 10.56% and 11.82% 4, while XIENCE V/XIENCE PRIME reported values of 15.77% and 13.62% 8.

Other interventions include Escitalopram, which showed a higher percentage of participants with an absence of mental stress-induced myocardial ischemia (MSIMI) compared to the control group (34.2% vs 17.5%) 6. Ranolazine was evaluated for perfusion defects and total perfusion deficit but did not reach statistical significance in these specific metrics (p=0.29 and p=0.22, respectively) 7. Other established trials included studies on medication 1, Clopidogrel 3, placebo plus aspirin 5, saline infusion 9, Methotrexate 11, Aspirin 12, Core size Xience Prime 13, Eptifibatide 14, and Ranolazine 22.

Recent results — preliminary, needs further review

  • * Heme arginate 3mg/kg showed significant increases in Myocardial HO-1 mRNA levels in both atrial (p=0.001) and ventricular tissue before aortic cross-clamping (p=0.002) 17. * CLBS14 (low-dose) was associated with a statistically significant reduction in the number of angina episodes per week at 6 and 12 months (p=0.020) and an increase in the duration of exercise on a modified Bruce protocol (p=0.014) 18. * PZ-128 was evaluated for safety and efficacy, though results are not yet corroborated 16. * Atorvastatin's effect on peri-operative inflammatory markers (Hs-CRP, IL-6) did not reach statistical significance 20. * Custodiol HTK was assessed regarding the need for postoperative inotropic infusion 21.

For the clinician treating this condition

  • Rivaroxaban 2.5 mg showed a statistically significant reduction in major cardiovascular outcomes including death, MI, and stroke 10.
  • The XIENCE V Everolimus Eluting Coronary Stent demonstrated significantly lower late loss and ischemia-driven target vessel failure compared to the control 15.
  • Escitalopram was associated with a higher percentage of patients showing an absence of mental stress-induced myocardial ischemia (MSIMI) 6.

AI synthesis of 21 cited trials, updated Jun 24, 2026. Informational only — not medical advice; trial data sourced from ClinicalTrials.gov. How we use AI.

Myocardial ischemia: current evidence & treatments

In patients with myocardial ischemia, several interventional strategies have been evaluated. For unprotected left main coronary artery disease, IVUS-guided PCI showed no significant difference compared to angiography-guided PCI for the primary composite outcome of stroke, myocardial infarction, revascularization, or death (HR 1.11; 95% CI 0.87-1.42; P=0.40) 1. In NSTEMI patients with multivessel disease, complete revascularization demonstrated a high probability of benefit over culprit-only revascularization for the composite endpoint of all-cause death, nonfatal MI, repeat revascularization, and stroke 9. For STEMI with multivessel disease, staged revascularization showed no significant difference versus immediate revascularization for major adverse cardiovascular events 14. In severe aortic stenosis patients with CAD, PCI before TAVR did not significantly reduce all-cause mortality or cardiovascular death but lowered revascularization needs at the cost of increased bleeding 22.

Pharmacological and non-pharmacological interventions also show promise. Colchicine reduced major adverse cardiovascular events and myocardial infarction in coronary artery disease without increasing serious adverse events 8. Inclisiran plus usual care improved LDL-C goal attainment after acute coronary syndrome, with 74.6% achieving LDL-C <70 mg/dL at Day 90 vs 26.6% with usual care (OR 10.84) 25. High-intensity interval aerobic exercise improved brachial flow-mediated dilation in coronary artery disease and heart failure 3. Baduanjin exercise improved outcomes in acute MI patients undergoing PCI 12. Additionally, pre-infection COVID-19 vaccination was associated with lower cardiovascular and cerebrovascular event risks in SARS-CoV-2 infected individuals 20.

Biomarkers and risk factors are also relevant. Higher pan-immune-inflammation value (PIV) was linked to worse outcomes after PCI for ACS (adjusted HR 1.65 for MACE; HR 3.51 for all-cause mortality) 4. Serum resistin levels increased progressively with worsening severity of coronary heart disease and acute MI 16. Breast arterial calcification on mammography predicted higher cardiovascular event risk in women (HR 1.82) 13 and was linked to increased cardiovascular mortality 19. Pre-transplant CAD increased all-cause mortality (HR 1.68) and post-transplant cardiovascular events in kidney recipients 2. Polygenic scores were associated with atherosclerosis and ischemic heart disease in Russian populations 7.

Key drugs in the evidence

sirolimus 1 everolimus 1

Latest findings

AI-generated synthesis of 15 cited studies, updated Jun 12, 2026. How we use AI.

HCP Mode — summaries include clinical detail, trial data, and statistical outcomes.
Patient Mode — summaries use plain language, avoiding clinical jargon.
Bidirectional Mendelian randomization suggests inverse association between hypertension liability and gastric cancer risk
Cardiology Cohort
Bidirectional Mendelian randomization suggests inverse association between hypertension liability and gastric cancer risk Could high blood pressure actually lower your risk of stomach cancer?
This bidirectional Mendelian randomization and retrospective clinical analysis included 45 individuals with gastric cancer cases and non-can…
Genetic evidence suggests a higher risk for high blood pressure might actually lower your risk of developing stomach cancer.
Frontiers Apr 21, 2026
Atorvastatin dose and PCI timing predict hypoperfusion in STEMI patients
Cardiology Cohort
Atorvastatin dose and PCI timing predict hypoperfusion in STEMI patients New Tool Predicts Heart Damage Risk After Emergency Stent Procedure
This cohort study evaluated 434 patients with acute ST-segment elevation myocardial infarction (STEMI) who underwent primary PCI.
This new tool could help doctors identify high-risk heart attack patients sooner, potentially improving survival and recovery rates.
Frontiers Apr 21, 2026
Narrative review on ultra-processed foods and cardiovascular disease mechanisms
Nutrition & Obesity Medicine Sys. Review
Narrative review on ultra-processed foods and cardiovascular disease mechanisms How Your Food Choices Rewire Your Heart Signals
This narrative review synthesizes evidence on ultra-processed foods and cardiovascular disease.
Ultra-processed foods may send bad signals to your heart cells by changing the tiny messages they use to stay healthy.
Frontiers Apr 20, 2026
Intrinsic capacity score predicts rehospitalization risk after PCI in CAD patients
Cardiology Cohort
Intrinsic capacity score predicts rehospitalization risk after PCI in CAD patients A Simple Score Predicts Heart Readmissions After Stent
This retrospective cohort study assessed intrinsic capacity (IC) scores within 48 hours of admission in patients with coronary artery diseas…
A quick conversation with a nurse can reveal if a heart patient is likely to need emergency care again soon.
Frontiers Apr 20, 2026
CMR-guided management improves treatment satisfaction in patients with ANOCA
Cardiology RCT
CMR-guided management improves treatment satisfaction in patients with ANOCA Does better imaging help patients with chest pain feel more satisfied with their care?
In this randomized controlled trial of 250 patients with suspected ANOCA, CMR-guided management significantly increased global treatment sat…
Advanced heart scans helped patients with chest pain feel much more satisfied with their care and receive better medications after six month…
Apr 19, 2026
CABG linked to higher impaired cognition risk in older CAD patients with APO genotype variation
Cardiology Cohort
CABG linked to higher impaired cognition risk in older CAD patients with APO genotype variation Heart Surgery Tied to Memory Issues in Some Patients
This cohort study of older adults with coronary artery disease found that coronary artery bypass grafting was associated with a higher risk …
Heart bypass surgery may raise memory problem risks in older adults, especially those carrying a specific gene type linked to brain health.
medRxiv Apr 19, 2026
Polygenic risk scores for coronary artery disease capture 10.8% to 33.1% of benchmark patients in early-onset CAD cohort
Genetics & Precision Medicine Cohort
Polygenic risk scores for coronary artery disease capture 10.8% to 33.1% of benchmark patients in early-onset CAD cohort New Test Finds Hidden Heart Risk in Healthy People
This observational cohort study evaluated polygenic risk scores (PRSs) for coronary artery disease in 1,184 early-onset patients with low 10…
A new way to test genetic heart risk shows current scores often miss people who need help.
medRxiv Apr 19, 2026
Prospective observational study identifies 2,504 potential drug-drug interactions among hospitalized patients with acute coronary syndrome
Drug Pipeline Cohort
Prospective observational study identifies 2,504 potential drug-drug interactions among hospitalized patients with acute coronary syndrome Heart Patients Face Hidden Risks From Common Drug Mixes
This prospective observational cohort study evaluated 371 hospitalized patients with acute coronary syndrome at Assiut University Heart Hosp…
Taking several heart medications at once can create dangerous hidden interactions that increase the risk of treatment failure and hospital s…
Frontiers Apr 19, 2026
Obesity-metabolic indices associated with heart failure in coronary artery disease patients
Diabetes & Endocrinology Cohort
Obesity-metabolic indices associated with heart failure in coronary artery disease patients Can a simple blood sugar number help predict heart failure risk?
This retrospective observational cohort study of 3,872 patients with coronary artery disease found that four obesity-metabolic indices were …
A simple blood sugar number called METS-IR is the best tool found so far to spot heart failure risk in patients with existing heart disease.
Frontiers Apr 19, 2026
Observational study links AI-detected proximal coronary calcium to higher MACE and mortality risk
Cardiology
Observational study links AI-detected proximal coronary calcium to higher MACE and mortality risk Does a tiny bit of calcium in your heart arteries mean higher risk for heart attacks or death?
This primary research article is an observational cohort study of 4,552 patients with mild coronary calcium and normal perfusion.
Calcium near the main entrance of heart arteries raises heart attack and death risk by 24% and 25% even when blood flow looks normal.
medRxiv Apr 19, 2026
Observational biobank study compares phenomic and social determinants for disease risk prediction
Genetics & Precision Medicine
Observational biobank study compares phenomic and social determinants for disease risk prediction Your Genes Aren’t Your Destiny: How Your Neighborhood Changes Your Risk
This research article from UK Biobank and other cohorts evaluates phenome-derived polygenic scores and social determinants for predicting as…
Your neighborhood and lifestyle can reshape your genetic risk for diseases like asthma and heart disease, offering a clearer health picture …
medRxiv Apr 19, 2026
Narrative review examines traditional Chinese medicine compounds for acute myocardial infarction without reported outcomes
Cardiology Sys. Review
Narrative review examines traditional Chinese medicine compounds for acute myocardial infarction without reported outcomes Saving Heart Muscle After a Heart Attack Means Fighting a Second Battle
This narrative review evaluates the use of compounds from traditional Chinese medicine in the context of acute myocardial infarction.
Opening a blocked artery after a heart attack can trigger a second wave of injury that kills heart muscle, so scientists are mapping new str…
Frontiers Apr 18, 2026

Questions about myocardial ischemia

Can a sirolimus-eluting iron bioresorbable scaffold treat coronary artery disease patients with myocardial ischemia?

A 2024 trial found that a sirolimus-eluting iron bioresorbable scaffold did not perform as well as standard metallic stents for treating coronary artery disease in patients with myocardial ischemia.

Full answer →
Which stent type shows better results for patients with myocardial ischemia in the Chinese trial?

A 2024 Chinese trial found that everolimus-eluting stents resulted in less late lumen loss compared to a new iron bioresorbable scaffold in patients with myocardial ischemia.

Full answer →
Does a sirolimus-eluting iron scaffold cause more late lumen loss than everolimus stents for myocardial ischemia?

Yes, the sirolimus-eluting iron scaffold (IBS) showed higher late lumen loss than the everolimus-eluting stent at 2 years in the IRONMAN-II trial.

Full answer →