Key result
Initial CTA shows no benefit over functional testing for DASI at 24 months.
Why the study?
The PROMISE trial previously showed no clinical outcome improvement with initial anatomic versus functional testing in stable symptomatic patients with suspected CAD, but symptom burden and quality of life effects remained to be clarified.
Does initial anatomic testing with computed tomography angiography improve quality of life compared to standard functional testing in symptomatic patients with suspected coronary artery disease?
RCT (n=5,985)
randomly assigned
Yes
Does initial anatomic testing with computed tomography angiography improve quality of life compared to standard functional testing in symptomatic patients with suspected coronary artery disease?
Mean Difference: 0.1 (95% CI -0.9–1.1)
In symptomatic patients with suspected CAD, an initial strategy of anatomic testing with CTA did not improve quality of life over 2 years compared to functional testing.
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Initial CTA offers no functional status benefit over functional testing at 2 years; leaves open optimal initial strategy in stable chest pain.
Mark et al. (2016) conducted an RCT in symptomatic patients with suspected coronary artery disease (n=5,985). Computed tomography angiography vs. Standard functional testing strategies was evaluated on Duke Activity Status Index at 24 months (MD 0.1, 95% CI -0.9 to 1.1). Initial anatomic testing with computed tomography angiography did not improve the Duke Activity Status Index compared to functional testing at 24 months (mean difference 0.1; 95% CI -0.9 to 1.1).
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