Health Status Outcomes After Computed Tomography or Invasive Coronary Angiography for Stable Chest Pain: A Prespecified Secondary Analysis of the DISCHARGE Randomized Clinical Trial
Authors' conclusion
Results of this secondary analysis of the DISCHARGE randomized clinical trial reveal that there was no significant difference in QOL or chest pain outcomes with CT vs ICA at 3.5 years.
Study context
- Population
- Patients with stable chest pain and intermediate probability of CAD, 26 European centres, 2015–20191,735 computed tomography (CT), 1671 invasive coronary angiography (ICA) with ≥1 assessment
- Participants
- 3,561 patients
- Comparison
- CT vs ICA as first test
- Primary endpoint
- QOL (EQ-5D-3L-VAS and SF-12-PCS) and angina
- Follow-up
- Median 3.5 years
Methodological detailsmulticentre, 26 European centres, prespecified outcomes, Median follow-up 3.5 years
- Multicentre
- 26 European centres
- Prespecified outcomes
- Median follow-up 3.5 years
Primary result
As reported in the abstract
Health status: EQ-5D-3L-VAS change (3.5 years minus baseline) and angina
| Group | Value | Within-group P |
|---|---|---|
| CT | mean change 4.0 (95% CI 3.1–4.9) | P < .001 |
| ICA | mean change 4.6 (95% CI 3.6–5.6) | P =.002 |
Value
CTmean change 4.0 (95% CI 3.1–4.9)
ICAmean change 4.6 (95% CI 3.6–5.6)
Within-group P
CTP < .001
ICAP =.002
Further findings
| Outcome | Difference (95% CI) | P value | |
|---|---|---|---|
| QOL by sex (men vs women)Menvs WomenBaseline EQ-5D-3L-VAS | 5.2 (4.0–6.3) | P < 0.001 | |
| QOL by sex (men vs women)Menvs WomenEQ-5D-3L-VAS at 3.5 years | 3.1 (1.9–4.4) | P < 0.001 | |
| QOL by sex (men vs women)Menvs WomenImprovement in EQ-5D-3L-VAS, greater in women | −1.9 (−3.4 to −0.5) | P = 0.009 | |
| QOL by sex (men vs women)Menvs WomenImprovement in SF-12-PCS, greater in women | −1.4 (−2.1 to −0.7) | P < 0.001 | |
| QOL by sex (men vs women)Menvs WomenImprovement in HADS-A, greater in women | 0.3 (0–0.7) | P = 0.04 | |
| −50510Difference (linear scale) |
| Outcome | CT | ICA | P value |
|---|---|---|---|
| HADS-D change (3.5 years minus baseline) · median 3.5 yearsMean change | −0.2 (95% CI −0.4–0) | −0.2 (95% CI −0.4–0) | |
| Within-group P | P = .04 | P = .12 | |
| Angina by sex, ICA (subgroup) · 1 yearFemale (ICA) vs Male (ICA) | P = 0.007 |
- HADS-D change (3.5 years minus baseline): abstract labels these values as "mean EQ-5D-3L-VAS 3.5 year minus baseline score"
- Angina by sex, ICA (subgroup): Female (ICA) 10.2%
- Angina by sex, ICA (subgroup): Male (ICA) 6.2%
HADS-D change (3.5 years minus baseline) · median 3.5 years
- HADS-D improved only in the CT group
Quality of life (QOL) by sex (men vs women)
- Female patients had worse baseline and follow-up QOL than male patients
Angina by sex, ICA (subgroup) · 1 year
- Similar 1-year angina rates by sex in the CT group
Original publication
Health Status Outcomes After Computed Tomography or Invasive Coronary Angiography for Stable Chest Pain: A Prespecified Secondary Analysis of the DISCHARGE Randomized Clinical Trial. JAMA Cardiol. Published 1 July 2025. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →