Strengthening the Case for CT-First: New Insights from the DISCHARGE Trial

Congratulations to Professor Jonathan Dodd and all those involved in the DISCHARGE Trial on their recently published research in RSNA’s Radiology: Cardiothoracic Imaging.

In patients with stable chest pain and low-intermediate probability of obstructive CAD, the team compared a CT-first strategy with an invasive coronary angiography (ICA)-first approach, focusing on downstream functional testing and patient management.

Key Findings:
• CT-first led to more functional testing, tailored to CAD severity (53.3% vs 24.3%; OR 3.55, P < .001)
• CT-first reduced revascularisations in both high-risk and non–high-risk CAD severity groups
• CT-first was associated with fewer major complications than ICA-first – across all CAD severity categories

These results reinforce growing international evidence for non-invasive CT as the preferred first-line strategy in evaluating stable chest pain.

In participants with stable chest pain and low to intermediate probability of obstructive coronary artery disease, a CT-first strategy led to increased functional testing influenced by disease severity, reduced revascularizations, and fewer major procedure-related complications compared with an invasive coronary angiography–first approach.

Read (opens in a new window)here.

Well done to all co-authors, collaborators, and trial centres.