Coronary disease & ACSSecondary analysis
Age and Computed Tomography and Invasive Coronary Angiography in Stable Chest Pain
- Secondary analysis of the DISCHARGE randomised trial
- assessor-blinded
- multicentre (26 European centres)
- prespecified age analysis
Conducted October 2015 to April 2019; analysed July 2022 to January 2023
Authors' conclusion
Age did not modify the effect of randomization group on the primary outcome of MACE but did modify the effect on major procedure-related complications.
Study context
- Population
- Patients referred for invasive coronary angiography (ICA) with stable chest pain and intermediate probability of obstructive CAD3,523 (99%) followed up
- Participants
- 3,561 patients
- Comparison
- Computed tomography (CT)-first vs direct-to-ICA strategy, by age
- Primary endpoint
- MACE (CV death, nonfatal MI or stroke), modification by age
- Follow-up
- Median 3.5 years
Primary result
As reported in the abstract
MACE: age × randomisation group interaction (age continuous) · median 3.5 years
Hazard ratio
1.02
95% CI 0.98–1.07
P = 0.31 for interaction
CT vs ICA
HR 1.02 (95% CI 0.98–1.07); P for interaction = 0.31
Safety
| Outcome | OR (95% CI) | P value | |
|---|---|---|---|
| Major procedure-related complications: age × randomisation group interaction · lower in younger patients | 1.15 (1.05–1.27) | P for interaction = 0.005 | |
| 0.512Odds ratio (log scale) |
Original publication
Age and Computed Tomography and Invasive Coronary Angiography in Stable Chest Pain. JAMA Cardiol. Published 1 April 2024. doi:10.1001/jamacardio.2024.0001
Summarised from the published abstract; every number is checked against it