Ischemic heart disease — statistics quick reference¶
Last curated: 2026-09-02. Every PMID added in this evidence expansion was live-resolved through PubMed E-utilities; all 22 retained NCT identifiers were re-resolved through ClinicalTrials.gov API v2. Estimates are not averaged across conflicting definitions.
Global burden¶
| Measure | Value | Year/population | Method/source |
|---|---|---|---|
| Prevalent IHD cases | 254.3M (95% UI 221.4–295.5M) | Global, 2021 | GBD modeled estimate (PMID 40841929) |
| IHD deaths | 9.0M (95% UI 8.3–9.5M) | Global, 2021 | GBD modeled estimate (PMID 40841929) |
| IHD DALYs | 188.4M | Global, 2021 | GBD modeled estimate (PMID 40841929) |
| Age-standardized IHD death-rate change | −31.6% | Global, 1990–2021 | GBD trend (PMID 40841929) |
| All-CVD deaths | 19.2M | Global, 2023 | GBD 2023 model (PMID 40990886) |
| All-CVD prevalent cases | 626M | Global, 2023 | GBD 2023 model (PMID 40990886) |
| IHD quality-of-care trend | Improved globally, wide SDI gradient | 195 countries, 1990–2017 | Modeled QCI (PMID 34041535) |
Stable-disease strategy trials¶
| Trial/measure | Value | Population/follow-up | Source |
|---|---|---|---|
| COURAGE randomized | 2,287 | Stable CAD | PMID 17387127 |
| COURAGE primary events | 19.0% vs 18.5%; HR 1.05 | PCI+OMT vs OMT, median 4.6 y | PMID 17387127 |
| ORBITA randomized | 200 | Single-vessel stable angina | PMID 29103656 |
| ORBITA exercise-time difference | +16.6 s; p=0.20 | PCI vs sham | PMID 29103656 |
| ISCHEMIA randomized | 5,179 | Moderate/severe ischemia | PMID 32227755 |
| ISCHEMIA 5-y primary estimate | 16.4% vs 18.2% | Invasive vs conservative | PMID 32227755 |
| ISCHEMIA deaths | 145 vs 144 | Initial invasive vs conservative | PMID 32227755 |
| ISCHEMIA-EXTEND all-cause mortality | 12.7% vs 13.4% | ~7 y | PMID 36335918 |
| ISCHEMIA-EXTEND CV mortality | 6.4% vs 8.6% | Invasive vs conservative | PMID 36335918 |
| ORBITA-2 randomized | 301 | Stable angina, little/no antianginal therapy | PMID 38015442 |
| ORBITA-2 angina score | 2.9 vs 5.6; OR 2.21 | PCI vs sham, 12 wk | PMID 38015442 |
| ERICA weekly angina episodes | 2.88 vs 3.31 | Ranolazine vs placebo, 6 wk | PMID 16875985 |
| ERICA weekly nitroglycerin use | 2.03 vs 2.68 tablets | Ranolazine vs placebo, 6 wk | PMID 16875985 |
Ischemic LV dysfunction and revascularization¶
| Measure | Value | Population | Source |
|---|---|---|---|
| REVIVED randomized | 700 | EF ≤35%, viable myocardium | PMID 36027563 |
| REVIVED death/HF hospitalization | 37.2% vs 38.0%; HR 0.99 | PCI+OMT vs OMT | PMID 36027563 |
| STICHES horizon | 10 y | Ischemic cardiomyopathy | PMID 27040723 |
| STICH3C target enrollment | 754 estimated | CABG vs PCI, recruiting | NCT05427370 |
| ISCHEMIA-CTO target enrollment | 1,560 estimated | CTO revascularization vs OMT | NCT03563417 |
| COMPLETE randomized | 4,041 | STEMI + multivessel disease | PMID 31475795 |
| CULPRIT-SHOCK death/renal replacement | 45.9% vs 55.4%; RR 0.83 (95% CI 0.71–0.96) | Culprit-only vs immediate multivessel PCI, shock | PMID 29083953 |
| STREAM-2 efficacy composite | 12.8% vs 13.3%; RR 0.96 (95% CI 0.62–1.48) | Half-dose tenecteplase strategy vs primary PCI, age ≥60 | PMID 37439219 |
| STREAM-2 intracranial hemorrhage | 1.5% vs 0% | Pharmaco-invasive vs primary PCI | PMID 37439219 |
| REVIVED viability interaction | None detected | PCI effect by viable/nonviable myocardium extent | PMID 37878295 |
| FREEDOM SAQ physical-limitation difference at 2 y | +4.4 points (95% CI 2.7–6.1) | CABG vs PCI, diabetes/multivessel CAD | PMID 24129463 |
Lipid lowering¶
| Measure | Value | Population/method | Source |
|---|---|---|---|
| Major vascular-event RR per 1 mmol/L LDL reduction | 0.78 | 170,000 participants/26 RCTs | PMID 21067804 |
| Further event reduction with intensive statin | 15% | Intensive vs less intensive | PMID 21067804 |
| IMPROVE-IT primary outcome | 32.7% vs 34.7%; HR 0.936 | Post-ACS, ezetimibe+statin vs statin | PMID 26039521 |
| FOURIER median achieved LDL-C | 30 mg/dL | Evolocumab arm | PMID 28304224 |
| FOURIER primary outcome | 9.8% vs 11.3%; HR 0.85 | Stable ASCVD | PMID 28304224 |
| ODYSSEY primary outcome | 9.5% vs 11.1%; HR 0.85 | Post-ACS alirocumab | PMID 30403574 |
| Inclisiran placebo-corrected LDL reduction | ~50% | ORION-10/11 | PMID 32187462 |
| REDUCE-IT primary outcome | 17.2% vs 22.0%; HR 0.75 | Statin-treated, elevated TG | PMID 30415628 |
| Lp(a)HORIZON enrollment | 8,323 actual | Pelacarsen; completed | NCT04023552 |
| OCEAN(a)-Outcomes enrollment | 7,297 actual | Olpasiran; active not recruiting | NCT05581303 |
| 4S all-cause mortality reduction | 30% relative | Simvastatin vs placebo, CHD | PMID 7968073 |
| 4S major coronary-event reduction | 34% relative | Simvastatin vs placebo, median 5.4 y | PMID 7968073 |
| TNT major cardiovascular events | HR 0.78 (95% CI 0.69–0.89) | Atorvastatin 80 vs 10 mg, stable CHD | PMID 15755765 |
| CLEAR Outcomes MACE | HR 0.87 (95% CI 0.79–0.96) | Bempedoic acid vs placebo, statin-intolerant high risk | PMID 36876740 |
Antithrombotic therapy¶
| Measure | Value | Population | Source |
|---|---|---|---|
| COMPASS MACE HR | 0.76 | Rivaroxaban 2.5 mg bid+aspirin vs aspirin | PMID 28844192 |
| COMPASS all-cause death HR | 0.82 | Stable CAD/PAD | PMID 28844192 |
| COMPASS major bleeding HR | 1.70 | Combination vs aspirin | PMID 28844192 |
| TWILIGHT BARC 2/3/5 bleeding | 4.0% vs 7.1%; HR 0.56 | Ticagrelor monotherapy vs ticagrelor+aspirin | PMID 31556978 |
| MASTER DAPT initial DAPT | 1 month | High-bleeding-risk PCI | PMID 34449185 |
| Standard ACS DAPT frame | Default then individualized | Contemporary ACS | ESC, PMID 37622654; ACC/AHA, PMID 40014670 |
| CURE CV death/MI/stroke | 9.3% vs 11.4%; RR 0.80 (95% CI 0.72–0.90) | Clopidogrel+aspirin vs aspirin, NSTE-ACS | PMID 11519503 |
| CURE major bleeding | 3.7% vs 2.7%; RR 1.38 | Clopidogrel+aspirin vs aspirin | PMID 11519503 |
| TRITON CV death/MI/stroke | 9.9% vs 12.1%; HR 0.81 (95% CI 0.73–0.90) | Prasugrel vs clopidogrel, PCI-planned ACS | PMID 17982182 |
| TRITON major bleeding | 2.4% vs 1.8%; HR 1.32 (95% CI 1.03–1.68) | Prasugrel vs clopidogrel | PMID 17982182 |
| PLATO CV death/MI/stroke | 9.8% vs 11.7%; HR 0.84 (95% CI 0.77–0.92) | Ticagrelor vs clopidogrel, ACS | PMID 19717846 |
| PEGASUS 60-mg efficacy | 7.77% vs 9.04%; HR 0.84 (95% CI 0.74–0.95) | Ticagrelor+aspirin vs aspirin, prior MI | PMID 25773268 |
| PEGASUS TIMI major bleeding | 2.30% vs 1.06% | Ticagrelor 60 mg vs placebo | PMID 25773268 |
| WOEST any bleeding | 19.4% vs 44.4%; HR 0.36 (95% CI 0.26–0.50) | OAC+clopidogrel vs triple therapy after PCI | PMID 23415013 |
| AUGUSTUS bleeding: apixaban vs VKA | 10.5% vs 14.7%; HR 0.69 (95% CI 0.58–0.81) | AF + ACS/PCI | PMID 30883055 |
| AUGUSTUS bleeding: aspirin vs placebo | 16.1% vs 9.0%; HR 1.89 (95% CI 1.59–2.24) | Background P2Y12+anticoagulation | PMID 30883055 |
| STOPDAPT-2 net composite | 2.36% vs 3.70%; HR 0.64 (95% CI 0.42–0.98) | 1-mo DAPT→clopidogrel vs 12-mo DAPT | PMID 31237644 |
| SMART-CHOICE BARC 2–5 bleeding | 2.0% vs 3.4%; HR 0.58 (95% CI 0.36–0.92) | 3-mo DAPT→P2Y12 vs 12-mo DAPT | PMID 31237645 |
Inflammation¶
| Trial/measure | Value | Population | Source |
|---|---|---|---|
| CANTOS 150-mg primary HR | 0.85 | Prior MI, hsCRP ≥2 mg/L | PMID 28845751 |
| CANTOS participants | 10,061 | Prior MI + inflammation | PMID 28845751 |
| COLCOT primary outcome | 5.5% vs 7.1%; HR 0.77 | Recent MI | PMID 31733140 |
| LoDoCo2 primary outcome | 6.8% vs 9.6%; HR 0.69 | Chronic coronary disease | PMID 32865380 |
| CLEAR SYNERGY | Neutral CV composite | Acute MI/PCI | PMID 39555823 |
| ARTEMIS target enrollment | 10,000 estimated | Ziltivekimab after MI | NCT06118281 |
| ZEUS enrollment | 6,385 actual | CVD + CKD + inflammation | NCT05021835 |
| TET2 colchicine enrollment | 120 estimated | Precision inflammation | NCT07362966 |
Rehabilitation, lifestyle, and adherence¶
| Measure | Value | Population/method | Source |
|---|---|---|---|
| CR cardiovascular mortality RR | 0.74 | 85-RCT meta-analysis | PMID 36746187 |
| CR cardiovascular mortality NNT | ~37 | Trial horizons | PMID 36746187 |
| CR hospitalization NNT | 37 | Median 12-month follow-up | PMID 36746187 |
| SECURE MACE | 9.5% vs 12.7%; HR 0.76 | Post-MI polypill vs usual care | PMID 36018037 |
| SELECT MACE | 6.5% vs 8.0%; HR 0.80 | Obesity + CVD, no diabetes | PMID 37952131 |
| Home vs center CR | Broadly similar outcomes | Selected RCT participants | PMID 37888805 |
Imaging, physiology, and INOCA¶
| Measure | Value | Population/method | Source |
|---|---|---|---|
| PROSPECT high-risk plaque burden | ≥70% | Non-culprit IVUS phenotype | PMID 21247313 |
| PROSPECT minimal lumen area | ≤4.0 mm² | High-risk phenotype | PMID 21247313 |
| CorMicA randomized | 151 | No obstructive CAD | PMID 30266608 |
| COSIMA target enrollment | 144 estimated | Refractory microvascular angina | NCT04606459 |
| ExINOCA target enrollment | 100 estimated | Exercise intervention | NCT06529848 |
| PREVENT enrollment | 1,608 actual | High-risk non-flow-limiting plaque | NCT02316886 |
| ORBITA-2 enrollment | 439 actual registered; 301 randomized report | Stable angina | NCT03742050; PMID 38015442 |
| ORBITA-COSMIC enrollment | Registry: 50 estimated; paper: 61 enrolled, 51 randomized, 50 in intention-to-treat analysis | Refractory angina | NCT04892537; PMID 38604209 |
Safety and special populations¶
| Statistic/contrast | Value | Population | Source |
|---|---|---|---|
| REDUCE-AMI finding | No reduction in death/new MI | Post-MI, preserved EF | PMID 38587241 |
| ABYSS inference | Interruption not shown noninferior | Stable post-MI | PMID 39213187 |
| Advanced CKD stable-CAD trial | Routine invasive strategy did not improve death/nonfatal MI | Advanced CKD + ischemia | PMID 32227756 |
| Sex-specific MI criteria | Changed symptom/troponin-defined recognition | Men and women with suspected ACS | PMID 31431112 |
Evidence-expansion quick reference — 2026-09-02¶
| Domain | Measure | Value | Population/method | Source |
|---|---|---|---|---|
| ACS | Routine oxygen, 1-year mortality | 5.0% vs 5.1%; HR 0.97 (95% CI 0.79–1.21) | 6,629 suspected-MI patients with saturation ≥90% | PMID 28844200 |
| Shock | Early ECLS, 30-day mortality | 47.8% vs 49.0%; RR 0.98 (95% CI 0.80–1.19) | 417 analyzed infarct-related shock patients | PMID 37634145 |
| Shock safety | Moderate/severe bleeding with ECLS | 23.4% vs 9.6%; RR 2.44 (95% CI 1.50–3.95) | ECLS-SHOCK | PMID 37634145 |
| Antithrombotics | Clopidogrel vs aspirin net outcome | 12.8% vs 16.9%; HR 0.74 (95% CI 0.63–0.86) | Event-free post-PCI patients; median 5.8 years | PMID 36342475 |
| Biomarkers | 1-hour hs-cTnT rule-out NPV | 99.9% (95% CI 99.3%–100%) | 1,320 suspected-MI presentations | PMID 25869867 |
| CR/lifestyle | Smoking cessation mortality | OR 0.54 (95% CI 0.46–0.62) | 12 post-MI cohorts, 5,878 patients | PMID 10761958 |
| Epidemiology | Young-adult CVD prevalence | 1,477.54→1,645.32 per 100,000 | GBD 1990–2019, age 15–39 | PMID 37365627 |
| Inflammation | CHIP in established ASCVD | HR 1.23 (95% CI 1.10–1.38) | 13,129 UK Biobank participants | PMID 37197843 |
| INOCA/MINOCA | MINOCA long-term MACE | 23.9% over mean 4.1 years | 9,136 30-day survivors | PMID 28179398 |
| Lipids | Inclisiran LDL-C change | −50.7% (95% CI −52.9% to −48.4%) | Pooled ORION-9/10/11, day 510 | PMID 33663735 |
| Revascularization | FAME 2 primary outcome | 13.9% vs 27.0%; HR 0.46 (95% CI 0.34–0.63) | FFR-positive stable disease, 5 years | PMID 29785878 |
| Patient outcomes | Return to work | 81.1% (95% CI 75.8%–85.8%) | 43 prospective studies, 34,964 patients | PMID 36097026 |
| Diagnostic safety | Missed ED discharge | MI 2.1%; unstable angina 2.3% | Prospective 10-hospital cohort | PMID 10770981 |
| Stable disease | MASS II 10-year survival | CABG 74.9%; PCI 75.1%; medical 69.0% | 611 randomized patients | PMID 20733102 |
These rows deliberately retain population and design boundaries. Historical cohorts, model-based GBD estimates, post-randomization survivor cohorts, and surrogate lipid changes are not pooled with contemporary intention-to-treat outcome trials.
Known conflicts and caveats¶
- Counts versus rates: absolute deaths/cases and age-standardized rates move in opposite directions when population growth and aging outpace risk reduction (Yang 2025, PMID 40841929; GBD CVD 2025, PMID 40990886).
- Composite endpoints: procedural MI, spontaneous MI, urgent revascularization, and hospitalization are not interchangeable; report components.
- Registry versus paper enrollment: NCT records may show screened/estimated/actual enrollment that differs from the randomized analysis population; both are retained where relevant.
- Rehabilitation eras: CR trials span decades of changing acute and preventive care, contributing heterogeneity (Dibben 2021, PMID 34741536; Dibben 2023, PMID 36746187).
- Colchicine conflict: COLCOT and LoDoCo2 were positive; CLEAR SYNERGY was neutral. Estimates are shown separately and not pooled here (Tardif 2019, PMID 31733140; Nidorf 2020, PMID 32865380; Jolly 2025, PMID 39555823).
- LDL floor: achieved LDL around 30 mg/dL was safe over FOURIER's median 2.2-year follow-up; that does not establish lifetime safety (PMID 28304224).
- Stable revascularization: COURAGE/ISCHEMIA address strategy in selected stable populations and do not include all left-main, unstable, severe-symptom, or severe-LV phenotypes.
- Model uncertainty: GBD uncertainty intervals, data availability, and cause redistribution must accompany rankings.
- Antithrombotic conditioning: aspirin-withdrawal and short-DAPT trials often randomize event-free patients at a post-PCI landmark; their bleeding benefit is not an estimate for patients with an early ischemic event or poor adherence.
- AF-PCI precision: WOEST, PIONEER AF-PCI, RE-DUAL PCI, AUGUSTUS, and ENTRUST-AF PCI consistently reduce bleeding with less aspirin/VKA exposure, but most were not powered to exclude small differences in rare ischemic events (PMID 23415013; PMID 27959713; PMID 28844193; PMID 30883055; PMID 31492505).
- Fibrinolysis tradeoff: STREAM-2's similar imprecise efficacy composite and higher intracranial hemorrhage must be shown together; it does not establish equivalence to timely primary PCI (PMID 37439219).