DISCHARGE Trial Summary: CT or Angio in Stable Chest Pain
June 8, 2022
2022 DISCHARGE TRIAL Summary: CT or Invasive Coronary Angiography in Stable Chest Pain- Pragmatic, randomized controlled trial- Objective: To evaluate computed tomography (CT) compared with invasive coronary angiography among patients with stable chest pain and intermediate pretest probability of obstructive coronary artery disease- 3561 patients- Inclusion Criteria: -At least 30 years of age -Stable chest pain -Intermediate pretest probability of obstructive CAD ст (n = 1,808) ICA (n = 1,753)- A PRIMARY OUTCOMES 2.1 CV death, nonfatal MI, or nonfatal stroke % HR 0.70; 95% CI, 0.46 to 1.07; P=0.10 3.0 SECONDARY OUTCOME 0.5 Major procedure-related complications % HR 0.26; 95% CI, 0.13 to 0.55 8.8 Angina during the final 4 wks of follow-up% OR 1.17; 95% CI, 0.92 to 1.48 7.5 Conclusion: Among patients referred for ICA because of stable chest pain and intermediate pretest probability of CAD, the risk of major adverse cardiovascular events was similar in the CT group and the ICA group. The frequency of major procedure-related complications was lower with an initial CT strategy. The DISCHARGE Trial Group. N Engl J Med 2022;Mar 4:[Epub ahead of print].