stable CAD: CT vs invasive angiography
A recent pragmatic, randomized controlled European trial compared CT angiography with invasive coronary angiography in patients with intermediate pretest probability of obstructive coronary artery disease (CAD) and stable chest pain, finding no significant difference in subsequent cardiac events but fewer major procedural complications with the CT (see cad stable CT vs invasive angio NEJM2022 in dropbox, or DOI: 10.1056/NEJMoa2200963), the DISCHARGE trial. Details: -- 3561 patients who had intermediate pretest probability of obstructive CAD and were referred to one of 26 European centers for invasive angiography (ICA), between October 2015 and April 2019 -- patients were randomized equally to CT vs ICA, with >97% adherence to the randomized assignments -- 56% women, median age 61, 80% were outpatient at the time of enrollment, 99% white, 41% employed/40% retired/2% disabled -- chest pain: typical angina 14%/atypical angina 46%/non-anginal ...