Ischemic heart disease — master index¶
Last curated: 2026-10-29 · status: mixed — 6 pages curated; 10 draft pages awaiting independent audit (2026-10-22 and 2026-10-29 sweeps)
Build at a glance: 16 wiki pages (6 curated, 10 draft) · 308 bibliography records (including corrections/co-publications) · 32 cited ClinicalTrials.gov records · 27 guideline/implementation documents · 6 landmark notes · 32 open questions · 6 cross-domain junctions · 9 patient organizations.
The condition in five sentences. Ischemic heart disease (IHD) spans chronic coronary syndromes and acute plaque/thrombotic events and accounted for an estimated 254.3 million prevalent cases, 9.0 million deaths, and 188.4 million DALYs in 2021 (Yang 2025, PMID 40841929). In stable disease, COURAGE and ISCHEMIA show that routine PCI/invasive management added to medical therapy does not reduce death or MI, while placebo-controlled ORBITA-2 shows that PCI does relieve concordant angina (Boden 2007, PMID 17387127; Maron 2020, PMID 32227755; Rajkumar 2023, PMID 38015442). Prognosis is driven principally by systemic prevention—LDL lowering, antithrombotic selection, smoking cessation, rehabilitation, adherence engineering, and treatment of cardiometabolic risk—while focal revascularization remains lifesaving in ACS and prognostic for selected anatomy or CABG-suitable ischemic LV dysfunction (CTT 2010, PMID 21067804; Velazquez 2016, PMID 27040723). Residual risk is biologically plural: plaque burden, Lp(a), inflammation, thrombosis, CKD, diabetes/adiposity, and delivery failure each demand different measures and trials (Ridker 2017, PMID 28845751; Bangalore 2020, PMID 32227756). The research frontier is selection—who benefits from which procedure, which anti-inflammatory or Lp(a) strategy, which INOCA endotype, and which implementation bundle in settings where cheap proven care remains least available.
Start here: Overview · frontier: Open questions · evidence ledger: Bibliography · history: Log
Reading paths¶
| Reader goal | Path |
|---|---|
| Understand the field | Overview → Epidemiology → Plaque biology |
| Manage stable symptoms | Stable CAD → Revascularization → INOCA |
| Understand acute care | ACS → Antithrombotics → Red flags |
| Build secondary prevention | Lipid lowering → Inflammation → Rehabilitation |
| Compare recommendations | Guidelines synthesis → Guideline registry |
| Study measurement/frontier | Biomarkers → Trials landscape → Open questions |
| Center lived experience | Patient experience → Patient-voice themes |
Pages¶
The Pages table is the canonical filename list for this condition.
| File | Scope | Status |
|---|---|---|
| overview.md | What IHD is, stable-CAD trial arc, secondary prevention, burden, map | curated |
| epidemiology-and-global-burden.md | GBD estimates, trends, SDI gradients, attribution, care quality | curated |
| pathophysiology-and-plaque-biology.md | Atherogenesis, rupture/erosion, vulnerable plaque, inflammation | curated |
| stable-cad-management.md | COURAGE/ORBITA/ISCHEMIA, symptom–prognosis split, antianginals | curated |
| acute-coronary-syndromes.md | STEMI/NSTEMI pathways, reperfusion, complete revascularization, post-ACS care | draft (sweeps 2026-10-22/29; awaiting audit) |
| revascularization-pci-and-cabg.md | PCI/CABG by anatomy, LV dysfunction, physiology guidance | draft (sweep 2026-10-22; awaiting audit) |
| lipid-lowering.md | Statins, ezetimibe, PCSK9, bempedoic acid, inclisiran, Lp(a) | draft (sweep 2026-10-22; awaiting audit) |
| antithrombotic-therapy.md | Aspirin, DAPT, monotherapy, dual pathway, bleeding | draft (sweep 2026-10-22; awaiting audit) |
| inflammation-and-residual-risk.md | CANTOS/CIRT/colchicine, hsCRP, IL-6, precision inflammation | draft (sweep 2026-10-22; awaiting audit) |
| cardiac-rehabilitation-and-lifestyle.md | CR outcomes/delivery, exercise, smoking, diet, adherence | draft (sweeps 2026-10-22/29; awaiting audit) |
| inoca-and-special-phenotypes.md | CMD, vasospasm, MINOCA, women, endotype-guided care | draft (sweeps 2026-10-22/29; awaiting audit) |
| guidelines.md | US/ESC acute/chronic synthesis and disagreements | draft (sweeps 2026-10-22/29; awaiting audit) |
| biomarkers.md | Troponin, hsCRP, Lp(a), PRS, CAC/CCTA plaque | draft (sweeps 2026-10-22/29; awaiting audit) |
| clinical-trials-landscape.md | Active/completed NCTs, sham trials, pipeline and design | draft (sweeps 2026-10-22/29; awaiting audit) |
| patient-experience-and-advocacy.md | Angina burden, fear, rehabilitation barriers, advocacy | curated |
| red-flags-and-safety-concerns.md | ACS recognition, bleeding, drug and exercise safety | curated |
Literature layer¶
| Resource | Contents | Status |
|---|---|---|
| BIBLIOGRAPHY.md | 308 resolved records with tags and citing files | sweep additions awaiting audit |
| notes/ | 6 landmark-paper deep notes | built |
| guidelines/REGISTRY.md | 27 current/superseded international documents, evidence shocks, implementation assumptions, disagreements, watch list | deepened |
| statistics/STATISTICS.md | Expanded quick-reference burden, trial, therapy, registry and safety effect estimates | deepened |
| patient-voice/README.md | Method, ethics, coverage limits | built |
| patient-voice/organizations.md | 9 official organizations across regions | built |
| patient-voice/themes.md | 8 themes, each triangulated by ≥2 sources | built |
| patient-voice/sources.md | Annotated peer-reviewed and public sources | built |
Curation state¶
The condition was built on 2026-08-28, deepened on 2026-08-30, widened on 2026-09-02 with 65 additional live-resolved PubMed records, and then audited on 2026-09-02 by a different engine (Claude) from the one that wrote the pages (Codex). That audit re-fetched all 252 PubMed records and all 22 ClinicalTrials.gov records live, checked every claim–citation pair, corrected the errors listed in LOG.md, and promoted all 16 pages to curated.
The 2026-10-29 sweep adds the Fifth Universal Definition of MI, dedicated ESC rehabilitation guidance, a verified UK mortality table, and an Asia-Pacific advocacy source; primary trial reports awaiting full-text appraisal are catalogued in the bibliography. See LOG.md for source coverage and follow-ups.