Computed tomography versus invasive coronary angiography: design and methods of the pragmatic randomised multicentre DISCHARGE trial
Authorized Users Only
AuthorsNapp, Adriane E.
Schuetz, Georg M.
Kofoed, Klaus Fuglsang
Dodd, Jonathan D.
Adjic, Nada Cemerlic
del Blanco, Bruno Garcia
Neskovic, Aleksandar N.
DISCHARGE Trial Grp
MetadataShow full item record
More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed. Computed tomography (CT) is the most accurate noninvasive test for detection and exclusion of coronary artery disease (CAD). To investigate the comparative effectiveness of CT and ICA, we designed the European pragmatic multicentre DISCHARGE trial funded by the 7th Framework Programme of the European Union (EC-GA 603266). In this trial, patients with a low-to-intermediate pretest probability (10-60 %) of suspected CAD and a clinical indication for ICA because of stable chest pain will be randomised in a 1-to-1 ratio to CT or ICA. CT and ICA findings guide subsequent management decisions by the local heart teams according to current evidence and European guidelines. Major adverse cardiovascular events (MACE) defined as cardiovascular death, myocardial infarct...ion and stroke as a composite endpoint will be the primary outcome measure. Secondary and other outcomes include cost-effectiveness, radiation exposure, health-related quality of life (HRQoL), socioeconomic status, lifestyle, adverse events related to CT/ICA, and gender differences. The DISCHARGE trial will assess the comparative effectiveness of CT and ICA. aEuro cent Coronary artery disease (CAD) is a major cause of morbidity and mortality. aEuro cent Invasive coronary angiography (ICA) is the reference standard for detection of CAD. aEuro cent Noninvasive computed tomography angiography excludes CAD with high sensitivity. aEuro cent CT may effectively reduce the approximately 2 million negative ICAs in Europe. aEuro cent DISCHARGE addresses this hypothesis in patients with low-to-intermediate pretest probability for CAD.
Keywords:Computed tomography / Angiography / Invasive coronary angiography / Adverse events / Comparative effectiveness
Source:European Radiology, 2017, 27, 7, 2957-2968
- Abbott, Academy of Finland, Centre of Excellence programs, Actelion, American Thoracic Society, Amgen, AP Moller og hustru Chastine McKinney Mollers Fond, Astra-Zeneca, Athera Biotechnologies AB, B. Braun Medical, Bayer, Bayer-Schering, Berlin Chemie, Beuth Hochschule fur Technik Berlin, Biosensors, Biotie Therapies, Biotronik, Boehringer-Ingelheim, Boston Scientific, Bracco, Braun, Cardiac MR Academy Berlin, CardiRad Ltd, Comac-Medical, Cordis, Covance, Directorate-General for Health and Food Safety, Eckert and Ziegler Radiopharma GmbH, Edwards Lifesciences, Endocyte Inc, European Regional Development Fund, European Society of Cardiology, European Union, F. Hoffmann-La Roche, Finnish Foundation for Cardiovascular Research, Fundacao para a Ciencia e Tecnologia, Portugal, GE Healthcare, Gedeon Richter, German Federal Ministry of Education and Research (BMBF), German Research Foundation (DFG), Guerbet, Guidotti, Intermeetings Padova, Irish Lung Foundation, Jansen-Cilag, Johnson Johnson, KRKA, Lantheus Inc, Medtronic, Medtronik, Menarini, Merck, Merck Sharp Dohme, MSD, National Heart, Lung, Blood Institute (NHLBI), Novartis, Orion Pharma, Pfizer, Pharma Swiss, Philips, Piramal, Portuguese Society of Cardiology, Quintiles, Research Council of Rigshopitalet, Roche, Sandoz, Sanofi Aventis, Schering, Servier, Siemens, Sigma Tau, Southeastern Health and Social Care Trust Innovation Research Development Group Fund, Spanish Society of Cardiology, St. Jude Medical, Stiftung Charit, Berlin Institute of Health, Takeda, TEKES Finland, Danish Agency for Science Technology and Innovation by The Danish Council for Strategic Research, Danish Heart Foundation, John and Birthe Meyer Foundation, Lundbeck Foundation, Toshiba Medical Systems, Turku University Hospital research funds, VITAL Images Inc., Zealand A/S, European Union [EC-GA 603266]