Computed tomography (CT) is a safe alternative to cardiac catheterization for patients with stable chest pain and suspected coronary artery disease (CAD) to rule out CAD as demonstrated by the randomized and multicentre DISCHARGE trial (https://www.nejm.org/doi/full/10.1056/NEJMoa2200963). Both, women and men benefit of using CT as the initial diagnostic test. CT is associated with lower frequency of procedural complications in women and a lower frequency of cardiovascular death, non-fatal myocardial infarction, non-fatal stroke, transient ischaemic attack, or major procedure related complications in men compared with a strategy of initial cardiac catheterization (Figure 1 A and B).

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Figure 1. A. Cumulative incidence curves for major procedure related complications. B. Cumulative incidence curves for secondary endpoint (expanded major adverse cardiovascular events (MACE) composite: cardiovascular death, myocardial infarction, stroke, transient ischaemic attack, or major procedure related complication).