Objective
Coronary artery disease (CAD) is the leading cause of death in high-income countries. Invasive coronary angiography (ICA) is the reference standard for the diagnosis of CAD and allows immediate therapy. However, only 40% of patients undergoing ICA actually have obstructive CAD and ICA has relatively rare but considerable risks. Coronary computed tomography (CT) is the most accurate diagnostic test for CAD currently available. CT may become the most effective strategy to reduce the ca. 2 million annual negative ICAs in Europe by enabling early and safe discharge of the majority of patients with an intermediate risk of CAD.
To evaluate this, we propose the DISCHARGE project that will be implemented by a multinational European consortium. The core of the project is the DISCHARGE pragmatic randomised controlled trial. The primary hypothesis will be that CT is superior to ICA for major adverse cardiovascular events (cardiovascular death, nonfatal myocardial infarction and stroke) after a maximum follow-up of 4 years in a selected broad population of stable chest pain patients with intermediate pretest likelihood of CAD. The trial will include 25 clinical sites from 16 European countries ensuring broad geographical representation. Comparative effectiveness research of complementing work packages include gender-related analysis, systematic review of evidence, cost-effectiveness analysis, and health-related quality of life. DISCHARGE has the capability to influence current standards and guidelines as well as coverage decisions and will raise awareness among patients, health care providers, and decision-makers in Europe about the effectiveness and cost-effectiveness of coronary CT angiography.
Fields of science
Call for proposal
FP7-HEALTH-2013-INNOVATION-1
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Funding Scheme
CP-FP - Small or medium-scale focused research projectCoordinator
10117 Berlin
Germany
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Participants (34)
6020 Innsbruck
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2650 Edegem
150 06 Praha 5
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3400 Hillerod
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73035 Goppingen
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04109 Leipzig
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1085 Budapest
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BT16 1RH Belfast
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4 Dublin
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09124 Cagliari
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00185 Roma
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1002 Riga
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44307 Kaunas
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51 124 Wroclaw
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4434 502 Vila Nova De Gaia
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540124 Targu Mures
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21204 Sremska Kamenica
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08007 Barcelona
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581 91 Linkoping
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9007 St. Gallen
G12 8QQ Glasgow
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L9 7AL Liverpool
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75654 Paris
2333 ZA Leiden
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48902 Barakaldo
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160 00 Praha
07747 Jena
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20520 Turku
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04 628 Warszawa
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540139 Targu Mures
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11000 Belgrade
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01006 Vitoria-gasteiz
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75014 Paris
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1165 Kobenhavn
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