LAUSR

In patients with stable chest pain, the use of CT provides a safe, accurate and non-invasive alternative to invasive coronary angiography (ICA) for the diagnosis of coronary artery disease (CAD). The DISCHARGE investigators randomly assigned 3,561 patients (56.2% women) with stable chest pain and an intermediate pretest probability of obstructive CAD to CT or ICA to guide treatment. Over 3.5 years of follow-up, major adverse cardiovascular events occurred in 2.1% of patients in the CT group compared with 3.0% of patients in the ICA group (HR 0.70). Major procedure-related complications occurred in 0.5% and 1.9% of each group, respectively (HR 0.26). The incidence of angina in the final 4 weeks of follow-up was not significantly different between the groups (8.8% versus 7.5%).