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Článek

PubMed

Záznam pochází z PubMed

Computed tomography versus invasive coronary angiography: design and methods of the pragmatic randomised multicentre DISCHARGE trial

European radiology. 2017 Jul ; 27 (7) : 2957-2968. [epub] 20161118

Eur Radiol
ISSN 1432-1084 | 0938-7994
Zdroj

Jazyk angličtina Země Německo Médium print-electronic

Typ dokumentu časopisecké články, multicentrická studie, randomizované kontrolované studie

Perzistentní odkaz https://www.medvik.cz/link/pmid27864607

Grantová podpora
MR/N003403/1 Medical Research Council - United Kingdom

PubMed 27864607
DOI 10.1007/s00330-016-4620-z
PII: 10.1007/s00330-016-4620-z
Knihovny.cz E-zdroje

Klíčová slova
Adverse events, Angiography, Comparative effectiveness, Computed tomography, Invasive coronary angiography,
MeSH
analýza nákladů a výnosů MeSH
hodnocení výsledků zdravotní péče * MeSH
koronární angiografie metody MeSH
kvalita života MeSH
lidé středního věku MeSH
lidé MeSH
následné studie MeSH
nemoci koronárních tepen diagnóza ekonomika MeSH
pilotní projekty MeSH
počítačová rentgenová tomografie metody MeSH
retrospektivní studie MeSH
senioři MeSH
Check Tag
lidé středního věku MeSH
lidé MeSH
mužské pohlaví MeSH
senioři MeSH
ženské pohlaví MeSH
Publikační typ
časopisecké články MeSH
multicentrická studie MeSH
randomizované kontrolované studie MeSH
Geografické názvy
Evropa MeSH

OBJECTIVES: More than 3.5 million invasive coronary angiographies (ICA) are performed in Europe annually. Approximately 2 million of these invasive procedures might be reduced by noninvasive tests because no coronary intervention is performed. Computed tomography (CT) is the most accurate noninvasive test for detection and exclusion of coronary artery disease (CAD). To investigate the comparative effectiveness of CT and ICA, we designed the European pragmatic multicentre DISCHARGE trial funded by the 7th Framework Programme of the European Union (EC-GA 603266). METHODS: In this trial, patients with a low-to-intermediate pretest probability (10-60 %) of suspected CAD and a clinical indication for ICA because of stable chest pain will be randomised in a 1-to-1 ratio to CT or ICA. CT and ICA findings guide subsequent management decisions by the local heart teams according to current evidence and European guidelines. RESULTS: Major adverse cardiovascular events (MACE) defined as cardiovascular death, myocardial infarction and stroke as a composite endpoint will be the primary outcome measure. Secondary and other outcomes include cost-effectiveness, radiation exposure, health-related quality of life (HRQoL), socioeconomic status, lifestyle, adverse events related to CT/ICA, and gender differences. CONCLUSIONS: The DISCHARGE trial will assess the comparative effectiveness of CT and ICA. KEY POINTS: • Coronary artery disease (CAD) is a major cause of morbidity and mortality. • Invasive coronary angiography (ICA) is the reference standard for detection of CAD. • Noninvasive computed tomography angiography excludes CAD with high sensitivity. • CT may effectively reduce the approximately 2 million negative ICAs in Europe. • DISCHARGE addresses this hypothesis in patients with low-to-intermediate pretest probability for CAD.

Basque Office for Health Technology Assessment Donostia San Sebastian 1 01010 Vitoria Gasteiz Spain

Clinical Coordinating Centre Charité Universitätsmedizin Berlin Campus Virchow Klinikum Augustenburger Platz 1 13353 Berlin Germany

Department of Cardiology Aintree University Hospital Longmoor Lane L9 7AL Liverpool UK

Department of Cardiology ALB FILS KLINIKEN GmbH Eichertstrasse 3 73035 Goeppingen Germany

Department of Cardiology Azienda Ospedaliera Brotzu Cagliari CA Italy

Department of Cardiology Basurto University Hospital Avenida Montevideo 18 48013 Bilbao Spain

Department of Cardiology Cardio Med Medical Center 22 decembrie 1989 540156 Targu Mures Romania

Department of Cardiology Centro Hospitalar de Vila Nova de Gaia Rua Conceicao Fernandes 4434 502 Vila Nova de Gaia Portugal

Department of Cardiology Charité Universitätsmedizin Berlin Charitéplatz 1 10117 Berlin Germany

Department of Cardiology Clinical Hospital Center Zemun Vukova 9 11080 Belgrade Zemun Serbia

Department of Cardiology Institute of Cardiovascular Diseases of Vojvodina Put dr Goldmana 4 212014 Novi Sad Sremska Kamenica Serbia

Department of Cardiology Lithuanian University of Health Sciences Eivelniu 2 50009 Kaunas Lithuania