6/28/23, 1:17 AM DISCHARGE Pathway Feedback Search Clinical Topics Home Studies DISCHARGE DISCHARGE Disease Disease Chest pain Coronary artery disease Trial question Is CT superior to invasive coronary angiography in guideline-directed management of stable chest pain? Study design Multi-center Open label RCT Population Characteristics of study participants 56.0% female N = 3561 44.0% male 3561 patients (2002 female, 1559 male) Inclusion criteria: patients with stable chest pain who had an intermediate pretest probability of obstructive coronary artery disease and were referred for invasive coronary angiography Key exclusion criteria: receipt of hemodialysis; absence of sinus rhythm; pregnancy Interventions N=1808 CT (clinical management decisions based on coronary CT angiography) N=1753 invasive coronary angiography (clinical management decisions based on invasive coronary angiography) Primary outcome https://web.pathway.md/studies/reckhNqoWaOSMrz7Y 1/2 6/28/23, 1:17 AM DISCHARGE Pathway Rate of composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke over 3.5 years 3.0 % 3 2.3 % 2.1 1.5 % 0.8 % No significant difference 0.0 % Computed tomography Invasive coronary angiography No significant difference in the rate of composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke over 3.5 years (2.1% vs. 3%; HR 0.7, 95% CI 0.46 to 1.07) Secondary outcomes Borderline significant decrease in major procedure-related complications (0.5% vs. 1.9%; HR 0.26, 95% CI 0.13 to 0.55) No significant difference in the rate of angina during at the last 4 weeks of follow-up (8.8% vs. 7.5%; OR 1.17, 95% CI 0.92 to 1.48) No significant difference in European quality of life-5 dimensions visual-analog scale score (71.8 vs. 71.1; MD 0.31, 95% CI -0.76 to 1.38) Conclusion In patients with stable chest pain who had an intermediate pretest probability of obstructive coronary artery disease and were referred for invasive coronary angiography, CT was not superior to invasive coronary angiography with respect to the rate of composite outcome of cardiovascular death, nonfatal myocardial infarction, or nonfatal stroke over 3.5 years. Reference DISCHARGE Trial Group, P l Maurovich-Horvat, Maria Bosserdt et al. CT or Invasive Coronary Angiography in Stable Chest Pain. N Engl J Med. 2022 Apr 28;386(17):1591-1602. Open reference URL https://web.pathway.md/studies/reckhNqoWaOSMrz7Y 2/2