CT Matches Invasive Angiography for Long-Term Quality of Life in Stable Chest Pain – New Findings from the DISCHARGE Trial

A new secondary analysis of the DISCHARGE randomized clinical trial has been published in JAMA Cardiology (May 14, 2025, doi: 10.1001/jamacardio.2025.0992). The study evaluated whether non-invasive computed tomography (CT) is as effective as invasive coronary angiography (ICA) in improving health-related quality of life (QOL) and reducing chest pain in patients with stable chest pain and intermediate risk of coronary artery disease.

Key results from 3561 patients across 26 European centers (median follow-up: 3.5 years):

  • No significant difference in long-term QOL outcomes between CT and ICA groups (EQ-5D-VAS, SF-12 scores).
  • Angina prevalence at 3.5 years was similar across groups.
  • Female patients had lower baseline and follow-up QOL, but showed greater relative improvements in physical and mental health measures.
  • Predictors of persistent chest pain included female sex, higher baseline pain, and depressive symptoms — not the choice of diagnostic modality.

Conclusion:
In stable chest pain, a CT-first diagnostic strategy offers comparable long-term patient-reported outcomes to invasive angiography. These results further support the use of CT as a non-invasive, patient-centered alternative in clinical decision-making.

Read the full article here: https://pubmed.ncbi.nlm.nih.gov/40366703/