Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease
An erratum to this article was published (Diabetes Care, 1 May 2024 ↗)
Authors' conclusion
In patients with diabetes referred for ICA for the investigation of stable chest pain, a CT-first strategy compared with an ICA-first strategy showed no difference in MACE and may potentially be associated with a lower rate of expanded MACE and major procedure-related complications.
Study context
- Population
- Patients with stable chest pain and intermediate pretest probability of coronary artery disease; subgroups with diabetes (n = 557: Computed tomography (CT) n = 263, invasive coronary angiography (ICA) n = 294) and without diabetes (n = 2,984: CT n = 1,536, ICA n = 1,448)557 with diabetes
- Participants
- 3,541 patients
- Comparison
- CT-first vs ICA-first strategy, in patients with and without diabetes
- Primary endpoint
- MACE:
- Cardiovascular death
- Nonfatal MI
- Stroke
- Follow-up
- Median 3.5 years
Methodological detailsmulticenter, 16 European countries
- Multicenter
- 16 European countries
Primary result
As reported in the abstract
MACE by diabetes status
- In both patients with and without diabetes, major adverse cardiac event (MACE) rate did not differ between CT and ICA
- CT vs ICA: P = 0.45
Secondary outcomes
| Outcome | CT | ICA | HR (95% CI) | |
|---|---|---|---|---|
| Expanded MACE (incl. transient ischemic attacks and major procedure-related complications), patients with diabetes · median 3.5 years | 3.8% | 8.2% | 0.45 (0.22–0.95) | |
| 0.20.5125Hazard ratio (log scale) |
- Expanded MACE, diabetes interaction · not statistically significant
- P = 0.35
Safety
| Outcome | CT | ICA | HR (95% CI) | |
|---|---|---|---|---|
| Major procedure-related complications, patients with diabetes · median 3.5 years | 0.4% | 2.7% | 0.30 (0.13–0.63) | |
| 0.10.31310Hazard ratio (log scale) |
| Outcome | P value |
|---|---|
| Major procedure-related complications, patients with diabetes · median 3.5 yearsNot statistically significant | P = 0.49 |
Original publication
Computed Tomography Versus Invasive Coronary Angiography in Patients With Diabetes and Suspected Coronary Artery Disease. Diabetes Care. Published 19 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →