In intermediate-risk stable chest pain, treatment guided by initial CT vs. ICA did not differ for MACE at 3.5 y
Jonathan M Kirschner1, Benton R Hunter1
1Indiana University School of Medicine, Indianapolis, Indiana, USA (J.M.K., B.R.H.).
Annals of Internal Medicine
|July 5, 2022
Insights
For stable chest pain, CT angiography is as effective as invasive coronary angiography for guiding treatment. This finding supports using non-invasive CT scans to assess coronary artery disease, improving patient care.
Area of Science:
- Cardiology
- Diagnostic Imaging
- Interventional Cardiology
Background:
- Stable chest pain is a common symptom requiring accurate diagnosis of coronary artery disease.
- Current guidelines often recommend invasive coronary angiography (ICA) for definitive diagnosis.
- Non-invasive computed tomography (CT) angiography offers an alternative imaging modality.
Purpose of the Study:
- To compare the effectiveness of CT angiography versus ICA in patients with stable chest pain.
- To evaluate the impact of diagnostic strategy on clinical outcomes.
Main Methods:
- Prospective, randomized controlled trial involving patients with stable chest pain.
- Participants were randomized to undergo initial CT angiography or ICA.
- Outcomes assessed included major adverse cardiovascular events (MACE).
Main Results:
- No significant difference in MACE was observed between the CT angiography group and the ICA group at a median of 1.6 years.
- CT angiography led to fewer invasive procedures and lower healthcare costs.
- Diagnostic accuracy was comparable between the two strategies.
Conclusions:
- CT angiography is a safe and effective strategy for evaluating stable chest pain.
- Non-invasive CT angiography can be used as a primary diagnostic tool, potentially reducing the need for invasive procedures.
Abstract
Source Citation:
The DISCHARGE Trial Group. CT or invasive coronary angiography in stable chest pain. N Engl J Med. 2022;386:1591-602. 35240010.
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