Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials
Authors' conclusion
Despite an overall good prognosis, low RF-CL patients have reduced risk of myocardial infarction or death when allocated to coronary CTA vs. usual care. Risk is similar in patients with very-low and moderate/high likelihood.
Study context
- Population
- Patients with stable chest pain, stratified by RF-CL: very-low (≤5%), low (>5%-15%), moderate/high (>15%)
- Participants
- 13,748 patients
- Comparison
- Coronary computed tomography angiography (CTA) vs usual care, by RF-CL
- Primary endpoint
- MI or death
- Follow-up
- 3 years
Methodological detailspooled analysis, stratified by RF-CL estimates
- Pooled analysis
- Stratified by RF-CL estimates
Primary result
As reported in the abstract
MI or death, by RF-CL (subgroups)
Coronary CTA vs Usual careHazard ratio (95% CI)
Very-low RF-CL; RD 0.3%
1.27(0.74–2.16)
Low RF-CL; RD 0.7%
0.67(0.47–0.97)
Moderate/high RF-CL; RD 0.5%
0.88(0.63–1.23)
- Very-low RF-CL patients
- 33%
- Low RF-CL patients
- 44%
- Moderate/high RF-CL patients
- 23%
Further findings
| Outcome | HR (95% CI) | |
|---|---|---|
| MI or death, overall · 3 yearsRD 0.3%; event rates similar | 0.84 (0.67–1.05) | |
| 0.512Hazard ratio (log scale) |
- MI or death, overall — Primary endpoint events, all patients
- 313 (2.3%)
Number needed to test with coronary CTA to prevent one event (low RF-CL) · 3 years
- Number needed to test
- 143
Original publication
Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials. Eur Heart J. Published 25 October 2024. doi:10.
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