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September 5, 2025Radiology Cardiothoracic Imaging

Comparative Analysis of Cardiac CT and Invasive Coronary Angiography for Suspected Stable Coronary Artery Disease and Subsequent Functional Testing and Revascularization: A Prespecified Secondary DISCHARGE Randomized Trial Analysis

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Authors

JDJonathan D. DoddMBMaria BosserdtAOAnna Oleksiak

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Overview

Randomized trial compares functional testing rates and outcomes of CT-first to ICA-first in stable chest pain patients, suggesting CT-first may reduce complications.

Key Points

  • CT-first strategy significantly increased functional testing rates for obstructive coronary artery disease, leading to 53.3% testing compared to 24.3% for ICA-first.
  • Participants experienced lower rates of revascularization for obstructive CAD with high-risk anatomy in the CT-first group, adjusted OR 0.3.
  • Major complications post-procedure were fewer in the CT-first strategy versus ICA-first, with 5.6% vs 2.0% for high-risk anatomy.
  • Angina rates after 3.5 years were comparable between CT-first and ICA-first strategies, indicating similar symptom control.

Cite This Study

Dodd et al. (2025) studied this question.

synapsesocial.com/papers/68c238d2b210217d647798fbhttps://doi.org/10.1148/ryct.240526
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Also Consider

Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Diagnostic Accuracy of CT Angiography in Stable Patients Suspected of Obstructive Coronary Artery Disease2025
  2. 2Comparison of Computed Tomogram Coronary Angiography (CTCA) alone versus CTCA with selective FFRCT in patients presenting with stable chest pain: a FORECAST trial substudy2025 · 2 citations
  3. 3Clinical Outcomes of Computed Tomography Coronary Angiography (CTCA) in Patients With Suspected Coronary Artery Disease: A Single‐Center Experience2025
  4. 4Comparative review of coronary CT angiography versus conventional catheter angiography: diagnostic value, clinical outcomes, and underlying technical principles2026
  5. 5Targeted Use of Computed Tomographic Coronary Angiography in Acute Chest Pain2026