Thread by @FCademartiri

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,...

...when business is too involved, then it is understandable (but not justifiable) that the more costly procedure and the one where self referral is at hand is privileged, but it is unethical if it is done at the expenses of patients risk and collective healthcare expenditures.

We must make a better use of our healthcare resources.

In addition, Cardiac CT is already known to be a much richer source of diagnostic and prognostic information as compared to all other test.

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CT or Invasive Coronary Angiography in Stable Chest Pain. The DISCHARGE Trial Group.

A chance to revise our approach to Cardiovascular Healthcare - Thread

#WhyCMR #yesCCT #CardioTwitter #MedTwitter

Fulltext @: nejm.org/doi/full/10.10…