Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial
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SYKES, Robert; Damien COLLISON; Bela MERKELY; Klaus F KOFOED; Patrick DONNELLY; Jose RODRIGUEZ-PALOMARES; Andrejs ERGLIS; Josef VESELKA; Gintare SAKALYTE; Nada CEMERLIC; Matthias GUTBERLET; Jonathan D DODD; Ignacio DIEZ; Gershan DAVIS; Elke ZIMMERMANN; Cezary KEPKA; Radosav VIDAKOVIC; Marco FRANCONE; Malgorzata ILNICKA-SUCKIEL; Fabian PLANK; Juhani KNUUTI; Rita FARIA; Stephen SCHROEDER; Colin BERRY; Luca SABA; Balazs RUZSICS; Nina RIECKMANN; Christine KUBIAK; Kristian SCHULTZ; Jacqueline MUELLER-NORDHORN; Pal MAUROVICH-HORVAT; Andreas D KNUDSEN; Imre BENEDEK; Clare ORR; Filipa Xavier VALENTE; Ligita ZVAIGZNE; Martin HORVATH; Antanas JANKAUSKAS; Filip ADIC; Michael WOINKE; Stephen KEANE; Inigo LECUMBERRI; Erica THWAITE; Michael LAULE; Mariusz KRUK; Aleksandra ZIVANIC; Massimo MANCONE; Donata KUSMIERZ; Gudrun FEUCHTNER; Mikko PIETILAE; Vasco Gama RIBEIRO; Tanja DROSCH; Christian DELLES; Michele PORCU; Michael FISHER; Tamas BARANY; Charlotte SORUM; Rosca AURELIAN; Stephanie KELLY; Bruno Garcia del BLANCO; Ainhoa RUBIO; Balint SZILVESZTER; Jawdat ABDULLA; Ioana RODEAN; Susan REGAN; Hug Cuellar CALABRIA; Milan VECSEY-NAGY; Birgit JURLANDER; Roxana HODAS; Sarah FEGER; Mahmoud MOHAMED; Lina M SERNA-HIGUITA; Konrad NEUMANN; Henryk DREGER; Matthias RIEF; Viktoria WIESKE; Maros FERENCIK; Melanie ESTRELLA; Maria BOSSERDT; Peter MARTUS; Theodora BENEDEK a Marc DEWEY
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Radiology, Chicago, The Radiological Society of North America, 2024, 0033-8419
When patients suspected of having coronary artery disease were stratified by body mass index category, no difference in clinical outcomes was observed between those who underwent initial management with CT and those who underwent invasive coronary angiography. Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019. Adult patients with stable chest pain and a CAD pretest probability of 10%–60% were randomly assigned to undergo initial CT or ICA. The primary end point was major adverse cardiovascular events (MACE), including cardiovascular death, nonfatal myocardial infarction, or stroke. The secondary end point was an expanded MACE composite, including transient ischemic attack, and major procedure-related complications. Competing risk analyses were performed using the Fine and Gray subdistribution Cox proportional hazard model to assess the impact of the relationship between BMI and initial management with CT or ICA on the study outcomes, whereas noncardiovascular death and unknown causes of death were considered competing risk events.
SYKES, Robert; Damien COLLISON; Bela MERKELY; Klaus F KOFOED; Patrick DONNELLY; Jose RODRIGUEZ-PALOMARES; Andrejs ERGLIS; Josef VESELKA; Gintare SAKALYTE; Nada CEMERLIC; Matthias GUTBERLET; Jonathan D DODD; Ignacio DIEZ; Gershan DAVIS; Elke ZIMMERMANN; Cezary KEPKA; Radosav VIDAKOVIC; Marco FRANCONE; Malgorzata ILNICKA-SUCKIEL; Fabian PLANK; Juhani KNUUTI; Rita FARIA; Stephen SCHROEDER; Colin BERRY; Luca SABA; Balazs RUZSICS; Nina RIECKMANN; Christine KUBIAK; Kristian SCHULTZ; Jacqueline MUELLER-NORDHORN; Pal MAUROVICH-HORVAT; Andreas D KNUDSEN; Imre BENEDEK; Clare ORR; Filipa Xavier VALENTE; Ligita ZVAIGZNE; Martin HORVATH; Antanas JANKAUSKAS; Filip ADIC; Michael WOINKE; Stephen KEANE; Inigo LECUMBERRI; Erica THWAITE; Michael LAULE; Mariusz KRUK; Aleksandra ZIVANIC; Massimo MANCONE; Donata KUSMIERZ; Gudrun FEUCHTNER; Mikko PIETILAE; Vasco Gama RIBEIRO; Tanja DROSCH; Christian DELLES; Michele PORCU; Michael FISHER; Tamas BARANY; Charlotte SORUM; Rosca AURELIAN; Stephanie KELLY; Bruno Garcia del BLANCO; Ainhoa RUBIO; Balint SZILVESZTER; Jawdat ABDULLA; Ioana RODEAN; Susan REGAN; Hug Cuellar CALABRIA; Milan VECSEY-NAGY; Birgit JURLANDER; Roxana HODAS; Sarah FEGER; Mahmoud MOHAMED; Lina M SERNA-HIGUITA; Konrad NEUMANN; Henryk DREGER; Matthias RIEF; Viktoria WIESKE; Maros FERENCIK; Melanie ESTRELLA; Maria BOSSERDT; Peter MARTUS; Theodora BENEDEK a Marc DEWEY. Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial. Radiology. Chicago: The Radiological Society of North America, 2024, roč. 310, č. 2, s. 1-13. ISSN 0033-8419. Dostupné z: https://dx.doi.org/10.1148/radiol.230591.
@article{2466317, author = {Sykes, Robert and Collison, Damien and Merkely, Bela and Kofoed, Klaus F and Donnelly, Patrick and RodriguezandPalomares, Jose and Erglis, Andrejs and Veselka, Josef and Sakalyte, Gintare and Cemerlic, Nada and Gutberlet, Matthias and Dodd, Jonathan D and Diez, Ignacio and Davis, Gershan and Zimmermann, Elke and Kepka, Cezary and Vidakovic, Radosav and Francone, Marco and IlnickaandSuckiel, Malgorzata and Plank, Fabian and Knuuti, Juhani and Faria, Rita and Schroeder, Stephen and Berry, Colin and Saba, Luca and Ruzsics, Balazs and Rieckmann, Nina and Kubiak, Christine and Schultz, Kristian and MuellerandNordhorn, Jacqueline and MaurovichandHorvat, Pal and Knudsen, Andreas D and Benedek, Imre and Orr, Clare and Valente, Filipa Xavier and Zvaigzne, Ligita and Horvath, Martin and Jankauskas, Antanas and Adic, Filip and Woinke, Michael and Keane, Stephen and Lecumberri, Inigo and Thwaite, Erica and Laule, Michael and Kruk, Mariusz and Zivanic, Aleksandra and Mancone, Massimo and Kusmierz, Donata and Feuchtner, Gudrun and Pietilae, Mikko and Ribeiro, Vasco Gama and Drosch, Tanja and Delles, Christian and Porcu, Michele and Fisher, Michael and Barany, Tamas and Sorum, Charlotte and Aurelian, Rosca and Kelly, Stephanie and Blanco, Bruno Garcia del and Rubio, Ainhoa and Szilveszter, Balint and Abdulla, Jawdat and Rodean, Ioana and Regan, Susan and Calabria, Hug Cuellar and VecseyandNagy, Milan and Jurlander, Birgit and Hodas, Roxana and Feger, Sarah and Mohamed, Mahmoud and SernaandHiguita, Lina M and Neumann, Konrad and Dreger, Henryk and Rief, Matthias and Wieske, Viktoria and Ferencik, Maros and Estrella, Melanie and Bosserdt, Maria and Martus, Peter and Benedek, Theodora and Dewey, Marc}, article_location = {Chicago}, article_number = {2}, doi = {http://dx.doi.org/10.1148/radiol.230591}, keywords = {BMI; coronary artery disease; cardiac CT;DISCHARGE Trial}, language = {eng}, issn = {0033-8419}, journal = {Radiology}, title = {Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial}, url = {https://pubs.rsna.org/doi/10.1148/radiol.230591}, volume = {310}, year = {2024} }
TY - JOUR ID - 2466317 AU - Sykes, Robert - Collison, Damien - Merkely, Bela - Kofoed, Klaus F - Donnelly, Patrick - Rodriguez-Palomares, Jose - Erglis, Andrejs - Veselka, Josef - Sakalyte, Gintare - Cemerlic, Nada - Gutberlet, Matthias - Dodd, Jonathan D - Diez, Ignacio - Davis, Gershan - Zimmermann, Elke - Kepka, Cezary - Vidakovic, Radosav - Francone, Marco - Ilnicka-Suckiel, Malgorzata - Plank, Fabian - Knuuti, Juhani - Faria, Rita - Schroeder, Stephen - Berry, Colin - Saba, Luca - Ruzsics, Balazs - Rieckmann, Nina - Kubiak, Christine - Schultz, Kristian - Mueller-Nordhorn, Jacqueline - Maurovich-Horvat, Pal - Knudsen, Andreas D - Benedek, Imre - Orr, Clare - Valente, Filipa Xavier - Zvaigzne, Ligita - Horvath, Martin - Jankauskas, Antanas - Adic, Filip - Woinke, Michael - Keane, Stephen - Lecumberri, Inigo - Thwaite, Erica - Laule, Michael - Kruk, Mariusz - Zivanic, Aleksandra - Mancone, Massimo - Kusmierz, Donata - Feuchtner, Gudrun - Pietilae, Mikko - Ribeiro, Vasco Gama - Drosch, Tanja - Delles, Christian - Porcu, Michele - Fisher, Michael - Barany, Tamas - Sorum, Charlotte - Aurelian, Rosca - Kelly, Stephanie - Blanco, Bruno Garcia del - Rubio, Ainhoa - Szilveszter, Balint - Abdulla, Jawdat - Rodean, Ioana - Regan, Susan - Calabria, Hug Cuellar - Vecsey-Nagy, Milan - Jurlander, Birgit - Hodas, Roxana - Feger, Sarah - Mohamed, Mahmoud - Serna-Higuita, Lina M - Neumann, Konrad - Dreger, Henryk - Rief, Matthias - Wieske, Viktoria - Ferencik, Maros - Estrella, Melanie - Bosserdt, Maria - Martus, Peter - Benedek, Theodora - Dewey, Marc PY - 2024 TI - Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial JF - Radiology VL - 310 IS - 2 SP - 1-13 EP - 1-13 PB - The Radiological Society of North America SN - 00338419 KW - BMI KW - coronary artery disease KW - cardiac CT;DISCHARGE Trial UR - https://pubs.rsna.org/doi/10.1148/radiol.230591 N2 - When patients suspected of having coronary artery disease were stratified by body mass index category, no difference in clinical outcomes was observed between those who underwent initial management with CT and those who underwent invasive coronary angiography. Background Recent trials support the role of cardiac CT in the evaluation of symptomatic patients suspected of having coronary artery disease (CAD); however, body mass index (BMI) has been reported to negatively impact CT image quality. Purpose To compare initial use of CT versus invasive coronary angiography (ICA) on clinical outcomes in patients with stable chest pain stratified by BMI category. Materials and Methods This prospective study represents a prespecified BMI subgroup analysis of the multicenter Diagnostic Imaging Strategies for Patients with Stable Chest Pain and Intermediate Risk of Coronary Artery Disease (DISCHARGE) trial conducted between October 2015 and April 2019. Adult patients with stable chest pain and a CAD pretest probability of 10%–60% were randomly assigned to undergo initial CT or ICA. The primary end point was major adverse cardiovascular events (MACE), including cardiovascular death, nonfatal myocardial infarction, or stroke. The secondary end point was an expanded MACE composite, including transient ischemic attack, and major procedure-related complications. Competing risk analyses were performed using the Fine and Gray subdistribution Cox proportional hazard model to assess the impact of the relationship between BMI and initial management with CT or ICA on the study outcomes, whereas noncardiovascular death and unknown causes of death were considered competing risk events. ER -
SYKES, Robert; Damien COLLISON; Bela MERKELY; Klaus F KOFOED; Patrick DONNELLY; Jose RODRIGUEZ-PALOMARES; Andrejs ERGLIS; Josef VESELKA; Gintare SAKALYTE; Nada CEMERLIC; Matthias GUTBERLET; Jonathan D DODD; Ignacio DIEZ; Gershan DAVIS; Elke ZIMMERMANN; Cezary KEPKA; Radosav VIDAKOVIC; Marco FRANCONE; Malgorzata ILNICKA-SUCKIEL; Fabian PLANK; Juhani KNUUTI; Rita FARIA; Stephen SCHROEDER; Colin BERRY; Luca SABA; Balazs RUZSICS; Nina RIECKMANN; Christine KUBIAK; Kristian SCHULTZ; Jacqueline MUELLER-NORDHORN; Pal MAUROVICH-HORVAT; Andreas D KNUDSEN; Imre BENEDEK; Clare ORR; Filipa Xavier VALENTE; Ligita ZVAIGZNE; Martin HORVATH; Antanas JANKAUSKAS; Filip ADIC; Michael WOINKE; Stephen KEANE; Inigo LECUMBERRI; Erica THWAITE; Michael LAULE; Mariusz KRUK; Aleksandra ZIVANIC; Massimo MANCONE; Donata KUSMIERZ; Gudrun FEUCHTNER; Mikko PIETILAE; Vasco Gama RIBEIRO; Tanja DROSCH; Christian DELLES; Michele PORCU; Michael FISHER; Tamas BARANY; Charlotte SORUM; Rosca AURELIAN; Stephanie KELLY; Bruno Garcia del BLANCO; Ainhoa RUBIO; Balint SZILVESZTER; Jawdat ABDULLA; Ioana RODEAN; Susan REGAN; Hug Cuellar CALABRIA; Milan VECSEY-NAGY; Birgit JURLANDER; Roxana HODAS; Sarah FEGER; Mahmoud MOHAMED; Lina M SERNA-HIGUITA; Konrad NEUMANN; Henryk DREGER; Matthias RIEF; Viktoria WIESKE; Maros FERENCIK; Melanie ESTRELLA; Maria BOSSERDT; Peter MARTUS; Theodora BENEDEK a Marc DEWEY. Effect of Body Mass Index on Effectiveness of CT versus Invasive Coronary Angiography in Stable Chest Pain: The DISCHARGE Trial. \textit{Radiology}. Chicago: The Radiological Society of North America, 2024, roč.~310, č.~2, s.~1-13. ISSN~0033-8419. Dostupné z: https://dx.doi.org/10.1148/radiol.230591.