Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial

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Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial. / Mancone, Massimo; Mézquita, Aldo J Vázquez; Birtolo, Lucia Ilaria; Maurovich-Horvat, Pal; Kofoed, Klaus F; Benedek, Theodora; Donnelly, Patrick; Rodriguez-Palomares, Jose; Erglis, Andrejs; Štěchovský, Cyril; Šakalytė, Gintare; Ađić, Nada Čemerlić; Gutberlet, Matthias; Diez, Ignacio; Davis, Gershan; Zimmermann, Elke; Kępka, Cezary; Vidakovic, Radosav; Francone, Marco; Ilnicka-Suckiel, Małgorzata; Plank, Fabian; Knuuti, Juhanni; Faria, Rita; Schröder, Stephen; Berry, Colin; Saba, Luca; Ruzsics, Balazs; Rieckmann, Nina; Kubiak, Christine; Hansen, Kristian Schultz; Müller-Nordhorn, Jaqueline; Merkely, Bela; Sigvardsen, Per E; Benedek, Imre; Orr, Clare; Valente, Filipa Xavier; Zvaigzne, Ligita; Suchánek, Vojtěch; Jankauskas, Antanas; Ađić, Filip; Woinke, Michael; Keane, Stephen; Lecumberri, Ignacio; Thwaite, Erica; Kruk, Mariusz; Jovanovic, Vladimir; Kuśmierz, Donata; Feuchtner, Gudren; Pietilä, Mikko; Ribeiro, Vasco Gama; Drosch, Tanja; Delles, Christian; Palmisano, Vitanio; Fisher, Michael; Drobni, Zsófia D; Kragelund, Charlotte; Aurelian, Rosca; Kelly, Stephanie; Del Blanco, Bruno Garcia; Rubio, Ainhoa; Boussoussou, Melinda; Hove, Jens D; Rodean, Ioana; Regan, Susan; Calabria, Hug Cuéllar; Becker, Dávid; Larsen, Linnea; Hodas, Roxana; Napp, Adriane E; Haase, Robert; Feger, Sarah; Mohamed, Mahmoud; Neumann, Konrad; Dreger, Henryk; Rief, Matthias; Wieske, Viktoria; Douglas, Pamela S; Estrella, Melanie; Bosserdt, Maria; Martus, Peter; Serna-Higuita, Lina M; Dodd, Jonathan D; Dewey, Marc.

In: European Radiology, 2024, p. 4127-4141.

Research output: Contribution to journal › Journal article › Research › peer-review

Harvard

Mancone, M, Mézquita, AJV, Birtolo, LI, Maurovich-Horvat, P, Kofoed, KF, Benedek, T, Donnelly, P, Rodriguez-Palomares, J, Erglis, A, Štěchovský, C, Šakalytė, G, Ađić, NČ, Gutberlet, M, Diez, I, Davis, G, Zimmermann, E, Kępka, C, Vidakovic, R, Francone, M, Ilnicka-Suckiel, M, Plank, F, Knuuti, J, Faria, R, Schröder, S, Berry, C, Saba, L, Ruzsics, B, Rieckmann, N, Kubiak, C, Hansen, KS, Müller-Nordhorn, J, Merkely, B, Sigvardsen, PE, Benedek, I, Orr, C, Valente, FX, Zvaigzne, L, Suchánek, V, Jankauskas, A, Ađić, F, Woinke, M, Keane, S, Lecumberri, I, Thwaite, E, Kruk, M, Jovanovic, V, Kuśmierz, D, Feuchtner, G, Pietilä, M, Ribeiro, VG, Drosch, T, Delles, C, Palmisano, V, Fisher, M, Drobni, ZD, Kragelund, C, Aurelian, R, Kelly, S, Del Blanco, BG, Rubio, A, Boussoussou, M, Hove, JD, Rodean, I, Regan, S, Calabria, HC, Becker, D, Larsen, L, Hodas, R, Napp, AE, Haase, R, Feger, S, Mohamed, M, Neumann, K, Dreger, H, Rief, M, Wieske, V, Douglas, PS, Estrella, M, Bosserdt, M, Martus, P, Serna-Higuita, LM, Dodd, JD & Dewey, M 2024, 'Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial', European Radiology, pp. 4127-4141. https://doi.org/10.1007/s00330-023-10355-2

APA

Mancone, M., Mézquita, A. J. V., Birtolo, L. I., Maurovich-Horvat, P., Kofoed, K. F., Benedek, T., Donnelly, P., Rodriguez-Palomares, J., Erglis, A., Štěchovský, C., Šakalytė, G., Ađić, N. Č., Gutberlet, M., Diez, I., Davis, G., Zimmermann, E., Kępka, C., Vidakovic, R., Francone, M., ... Dewey, M. (2024). Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial. European Radiology, 4127-4141. https://doi.org/10.1007/s00330-023-10355-2

Vancouver

Mancone M, Mézquita AJV, Birtolo LI, Maurovich-Horvat P, Kofoed KF, Benedek T et al. Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial. European Radiology. 2024;4127-4141. https://doi.org/10.1007/s00330-023-10355-2

Author

Mancone, Massimo ; Mézquita, Aldo J Vázquez ; Birtolo, Lucia Ilaria ; Maurovich-Horvat, Pal ; Kofoed, Klaus F ; Benedek, Theodora ; Donnelly, Patrick ; Rodriguez-Palomares, Jose ; Erglis, Andrejs ; Štěchovský, Cyril ; Šakalytė, Gintare ; Ađić, Nada Čemerlić ; Gutberlet, Matthias ; Diez, Ignacio ; Davis, Gershan ; Zimmermann, Elke ; Kępka, Cezary ; Vidakovic, Radosav ; Francone, Marco ; Ilnicka-Suckiel, Małgorzata ; Plank, Fabian ; Knuuti, Juhanni ; Faria, Rita ; Schröder, Stephen ; Berry, Colin ; Saba, Luca ; Ruzsics, Balazs ; Rieckmann, Nina ; Kubiak, Christine ; Hansen, Kristian Schultz ; Müller-Nordhorn, Jaqueline ; Merkely, Bela ; Sigvardsen, Per E ; Benedek, Imre ; Orr, Clare ; Valente, Filipa Xavier ; Zvaigzne, Ligita ; Suchánek, Vojtěch ; Jankauskas, Antanas ; Ađić, Filip ; Woinke, Michael ; Keane, Stephen ; Lecumberri, Ignacio ; Thwaite, Erica ; Kruk, Mariusz ; Jovanovic, Vladimir ; Kuśmierz, Donata ; Feuchtner, Gudren ; Pietilä, Mikko ; Ribeiro, Vasco Gama ; Drosch, Tanja ; Delles, Christian ; Palmisano, Vitanio ; Fisher, Michael ; Drobni, Zsófia D ; Kragelund, Charlotte ; Aurelian, Rosca ; Kelly, Stephanie ; Del Blanco, Bruno Garcia ; Rubio, Ainhoa ; Boussoussou, Melinda ; Hove, Jens D ; Rodean, Ioana ; Regan, Susan ; Calabria, Hug Cuéllar ; Becker, Dávid ; Larsen, Linnea ; Hodas, Roxana ; Napp, Adriane E ; Haase, Robert ; Feger, Sarah ; Mohamed, Mahmoud ; Neumann, Konrad ; Dreger, Henryk ; Rief, Matthias ; Wieske, Viktoria ; Douglas, Pamela S ; Estrella, Melanie ; Bosserdt, Maria ; Martus, Peter ; Serna-Higuita, Lina M ; Dodd, Jonathan D ; Dewey, Marc. / Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial. In: European Radiology. 2024 ; pp. 4127-4141.

Bibtex

@article{b91f41d0cf264f5189fc6082644aba92,

title = "Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial",

abstract = "OBJECTIVES: To investigate if the effect of cardiac computed tomography (CT) vs. invasive coronary angiography (ICA) on cardiovascular events differs based on smoking status.MATERIALS AND METHODS: This pre-specified subgroup analysis of the pragmatic, prospective, multicentre, randomised DISCHARGE trial (NCT02400229) involved 3561 patients with suspected coronary artery disease (CAD). The primary endpoint was major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, or stroke). Secondary endpoints included an expanded MACE composite (MACE, transient ischaemic attack, or major procedure-related complications).RESULTS: Of 3445 randomised patients with smoking data (mean age 59.1 years + / - 9.7, 1151 men), at 3.5-year follow-up, the effect of CT vs. ICA on MACE was consistent across smoking groups (p for interaction = 0.98). The percutaneous coronary intervention rate was significantly lower with a CT-first strategy in smokers and former smokers (p = 0.01 for both). A CT-first strategy reduced the hazard of major procedure-related complications (HR: 0.21, 95% CI: 0.03, 0.81; p = 0.045) across smoking groups. In current smokers, the expanded MACE composite was lower in the CT- compared to the ICA-first strategy (2.3% (8) vs 6.0% (18), HR: 0.38; 95% CI: 0.17, 0.88). The rate of non-obstructive CAD was significantly higher in all three smoking groups in the CT-first strategy.CONCLUSION: For patients with stable chest pain referred for ICA, the clinical outcomes of CT were consistent across smoking status. The CT-first approach led to a higher detection rate of non-obstructive CAD and fewer major procedure-related complications in smokers.CLINICAL RELEVANCE STATEMENT: This pre-specified sub-analysis of the DISCHARGE trial confirms that a CT-first strategy in patients with stable chest pain referred for invasive coronary angiography with an intermediate pre-test probability of coronary artery disease is as effective as and safer than invasive coronary angiography, irrespective of smoking status.TRIAL REGISTRATION: ClinicalTrials.gov NCT02400229.KEY POINTS: • No randomised studies have assessed smoking status on CT effectiveness in symptomatic patients referred for invasive coronary angiography. • A CT-first strategy results in comparable adverse events, fewer complications, and increased coronary artery disease detection, irrespective of smoking status. • A CT-first strategy is safe and effective for stable chest pain patients with intermediate pre-test probability for CAD, including never smokers.",

author = "Massimo Mancone and M{\'e}zquita, {Aldo J V{\'a}zquez} and Birtolo, {Lucia Ilaria} and Pal Maurovich-Horvat and Kofoed, {Klaus F} and Theodora Benedek and Patrick Donnelly and Jose Rodriguez-Palomares and Andrejs Erglis and Cyril {\v S}t{\v e}chovsk{\'y} and Gintare {\v S}akalytė and A{\d}i{\'c}, {Nada {\v C}emerli{\'c}} and Matthias Gutberlet and Ignacio Diez and Gershan Davis and Elke Zimmermann and Cezary K{\c e}pka and Radosav Vidakovic and Marco Francone and Ma{\l}gorzata Ilnicka-Suckiel and Fabian Plank and Juhanni Knuuti and Rita Faria and Stephen Schr{\"o}der and Colin Berry and Luca Saba and Balazs Ruzsics and Nina Rieckmann and Christine Kubiak and Hansen, {Kristian Schultz} and Jaqueline M{\"u}ller-Nordhorn and Bela Merkely and Sigvardsen, {Per E} and Imre Benedek and Clare Orr and Valente, {Filipa Xavier} and Ligita Zvaigzne and Vojt{\v e}ch Such{\'a}nek and Antanas Jankauskas and Filip A{\d}i{\'c} and Michael Woinke and Stephen Keane and Ignacio Lecumberri and Erica Thwaite and Mariusz Kruk and Vladimir Jovanovic and Donata Ku{\'s}mierz and Gudren Feuchtner and Mikko Pietil{\"a} and Ribeiro, {Vasco Gama} and Tanja Drosch and Christian Delles and Vitanio Palmisano and Michael Fisher and Drobni, {Zs{\'o}fia D} and Charlotte Kragelund and Rosca Aurelian and Stephanie Kelly and {Del Blanco}, {Bruno Garcia} and Ainhoa Rubio and Melinda Boussoussou and Hove, {Jens D} and Ioana Rodean and Susan Regan and Calabria, {Hug Cu{\'e}llar} and D{\'a}vid Becker and Linnea Larsen and Roxana Hodas and Napp, {Adriane E} and Robert Haase and Sarah Feger and Mahmoud Mohamed and Konrad Neumann and Henryk Dreger and Matthias Rief and Viktoria Wieske and Douglas, {Pamela S} and Melanie Estrella and Maria Bosserdt and Peter Martus and Serna-Higuita, {Lina M} and Dodd, {Jonathan D} and Marc Dewey",

note = "{\textcopyright} 2023. The Author(s), under exclusive licence to European Society of Radiology.",

year = "2024",

doi = "10.1007/s00330-023-10355-2",

language = "English",

pages = "4127--4141",

journal = "European Radiology",

issn = "0938-7994",

publisher = "Springer",

}

RIS

TY - JOUR

T1 - Impact of smoking in patients with suspected coronary artery disease in the randomised DISCHARGE trial

AU - Mancone, Massimo

AU - Mézquita, Aldo J Vázquez

AU - Birtolo, Lucia Ilaria

AU - Maurovich-Horvat, Pal

AU - Kofoed, Klaus F

AU - Benedek, Theodora

AU - Donnelly, Patrick

AU - Rodriguez-Palomares, Jose

AU - Erglis, Andrejs

AU - Štěchovský, Cyril

AU - Šakalytė, Gintare

AU - Ađić, Nada Čemerlić

AU - Gutberlet, Matthias

AU - Diez, Ignacio

AU - Davis, Gershan

AU - Zimmermann, Elke

AU - Kępka, Cezary

AU - Vidakovic, Radosav

AU - Francone, Marco

AU - Ilnicka-Suckiel, Małgorzata

AU - Plank, Fabian

AU - Knuuti, Juhanni

AU - Faria, Rita

AU - Schröder, Stephen

AU - Berry, Colin

AU - Saba, Luca

AU - Ruzsics, Balazs

AU - Rieckmann, Nina

AU - Kubiak, Christine

AU - Hansen, Kristian Schultz

AU - Müller-Nordhorn, Jaqueline

AU - Merkely, Bela

AU - Sigvardsen, Per E

AU - Benedek, Imre

AU - Orr, Clare

AU - Valente, Filipa Xavier

AU - Zvaigzne, Ligita

AU - Suchánek, Vojtěch

AU - Jankauskas, Antanas

AU - Ađić, Filip

AU - Woinke, Michael

AU - Keane, Stephen

AU - Lecumberri, Ignacio

AU - Thwaite, Erica

AU - Kruk, Mariusz

AU - Jovanovic, Vladimir

AU - Kuśmierz, Donata

AU - Feuchtner, Gudren

AU - Pietilä, Mikko

AU - Ribeiro, Vasco Gama

AU - Drosch, Tanja

AU - Delles, Christian

AU - Palmisano, Vitanio

AU - Fisher, Michael

AU - Drobni, Zsófia D

AU - Kragelund, Charlotte

AU - Aurelian, Rosca

AU - Kelly, Stephanie

AU - Del Blanco, Bruno Garcia

AU - Rubio, Ainhoa

AU - Boussoussou, Melinda

AU - Hove, Jens D

AU - Rodean, Ioana

AU - Regan, Susan

AU - Calabria, Hug Cuéllar

AU - Becker, Dávid

AU - Larsen, Linnea

AU - Hodas, Roxana

AU - Napp, Adriane E

AU - Haase, Robert

AU - Feger, Sarah

AU - Mohamed, Mahmoud

AU - Neumann, Konrad

AU - Dreger, Henryk

AU - Rief, Matthias

AU - Wieske, Viktoria

AU - Douglas, Pamela S

AU - Estrella, Melanie

AU - Bosserdt, Maria

AU - Martus, Peter

AU - Serna-Higuita, Lina M

AU - Dodd, Jonathan D

AU - Dewey, Marc

PY - 2024

Y1 - 2024

N2 - OBJECTIVES: To investigate if the effect of cardiac computed tomography (CT) vs. invasive coronary angiography (ICA) on cardiovascular events differs based on smoking status.MATERIALS AND METHODS: This pre-specified subgroup analysis of the pragmatic, prospective, multicentre, randomised DISCHARGE trial (NCT02400229) involved 3561 patients with suspected coronary artery disease (CAD). The primary endpoint was major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, or stroke). Secondary endpoints included an expanded MACE composite (MACE, transient ischaemic attack, or major procedure-related complications).RESULTS: Of 3445 randomised patients with smoking data (mean age 59.1 years + / - 9.7, 1151 men), at 3.5-year follow-up, the effect of CT vs. ICA on MACE was consistent across smoking groups (p for interaction = 0.98). The percutaneous coronary intervention rate was significantly lower with a CT-first strategy in smokers and former smokers (p = 0.01 for both). A CT-first strategy reduced the hazard of major procedure-related complications (HR: 0.21, 95% CI: 0.03, 0.81; p = 0.045) across smoking groups. In current smokers, the expanded MACE composite was lower in the CT- compared to the ICA-first strategy (2.3% (8) vs 6.0% (18), HR: 0.38; 95% CI: 0.17, 0.88). The rate of non-obstructive CAD was significantly higher in all three smoking groups in the CT-first strategy.CONCLUSION: For patients with stable chest pain referred for ICA, the clinical outcomes of CT were consistent across smoking status. The CT-first approach led to a higher detection rate of non-obstructive CAD and fewer major procedure-related complications in smokers.CLINICAL RELEVANCE STATEMENT: This pre-specified sub-analysis of the DISCHARGE trial confirms that a CT-first strategy in patients with stable chest pain referred for invasive coronary angiography with an intermediate pre-test probability of coronary artery disease is as effective as and safer than invasive coronary angiography, irrespective of smoking status.TRIAL REGISTRATION: ClinicalTrials.gov NCT02400229.KEY POINTS: • No randomised studies have assessed smoking status on CT effectiveness in symptomatic patients referred for invasive coronary angiography. • A CT-first strategy results in comparable adverse events, fewer complications, and increased coronary artery disease detection, irrespective of smoking status. • A CT-first strategy is safe and effective for stable chest pain patients with intermediate pre-test probability for CAD, including never smokers.

AB - OBJECTIVES: To investigate if the effect of cardiac computed tomography (CT) vs. invasive coronary angiography (ICA) on cardiovascular events differs based on smoking status.MATERIALS AND METHODS: This pre-specified subgroup analysis of the pragmatic, prospective, multicentre, randomised DISCHARGE trial (NCT02400229) involved 3561 patients with suspected coronary artery disease (CAD). The primary endpoint was major adverse cardiovascular events (MACE: cardiovascular death, non-fatal myocardial infarction, or stroke). Secondary endpoints included an expanded MACE composite (MACE, transient ischaemic attack, or major procedure-related complications).RESULTS: Of 3445 randomised patients with smoking data (mean age 59.1 years + / - 9.7, 1151 men), at 3.5-year follow-up, the effect of CT vs. ICA on MACE was consistent across smoking groups (p for interaction = 0.98). The percutaneous coronary intervention rate was significantly lower with a CT-first strategy in smokers and former smokers (p = 0.01 for both). A CT-first strategy reduced the hazard of major procedure-related complications (HR: 0.21, 95% CI: 0.03, 0.81; p = 0.045) across smoking groups. In current smokers, the expanded MACE composite was lower in the CT- compared to the ICA-first strategy (2.3% (8) vs 6.0% (18), HR: 0.38; 95% CI: 0.17, 0.88). The rate of non-obstructive CAD was significantly higher in all three smoking groups in the CT-first strategy.CONCLUSION: For patients with stable chest pain referred for ICA, the clinical outcomes of CT were consistent across smoking status. The CT-first approach led to a higher detection rate of non-obstructive CAD and fewer major procedure-related complications in smokers.CLINICAL RELEVANCE STATEMENT: This pre-specified sub-analysis of the DISCHARGE trial confirms that a CT-first strategy in patients with stable chest pain referred for invasive coronary angiography with an intermediate pre-test probability of coronary artery disease is as effective as and safer than invasive coronary angiography, irrespective of smoking status.TRIAL REGISTRATION: ClinicalTrials.gov NCT02400229.KEY POINTS: • No randomised studies have assessed smoking status on CT effectiveness in symptomatic patients referred for invasive coronary angiography. • A CT-first strategy results in comparable adverse events, fewer complications, and increased coronary artery disease detection, irrespective of smoking status. • A CT-first strategy is safe and effective for stable chest pain patients with intermediate pre-test probability for CAD, including never smokers.

U2 - 10.1007/s00330-023-10355-2

DO - 10.1007/s00330-023-10355-2

M3 - Journal article

C2 - 37991508

SP - 4127

EP - 4141

JO - European Radiology

JF - European Radiology

SN - 0938-7994

ER -

ID: 377783116

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