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The DISCHARGE trial in online on the NEJM and it confirms what we all experience every day using CCT in a proper manner. CCT is safer, reliable and allows better management of stable patients with suspected obstructive CAD as compared to invasive strategy.
The main observation that comes to my mind however is still the very low prevalence of patients with obstructive CAD (25%) in both arms (CT and ICA). This is well known from previous studies and it is related to the selection criteria adopted for referral, partly.
The fact that still we send for an invasive and costly examination (CAG/ICA) this huge number of patients is simply astonishing in 2022. Healthcare cannot be managed like this, especially in universal systems like Italy, Germany, UK, Canada,...
