Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the Scottish Computed Tomography of the Heart (SCOT-HEART) randomised controlled trial in Scotland
Primary result · CHD death or non-fatal MIResult — go to the resultHazard ratio 0.79 95% CI 0.63–0.99Authors' conclusion
After 10 years, CCTA-guided management of patients with stable chest pain was associated with a sustained reduction in coronary heart disease death or non-fatal myocardial infarction.
Study context
- Population
- Patients aged 18–75 years with suspected stable angina due to CHD, 12 outpatient cardiology chest pain clinics, Scotland
- Participants
- 4,146 patients
- Comparison
- Standard care plus coronary CT angiography (CCTA) vs standard care alone
- CCTAn = 2,073
- Standard caren = 2,073reference
- Primary endpoint
- CHD death or non-fatal MI
- Follow-up
- Median 10.0 years (IQR 9.3-11.0)
Methodological detailsopen-label, multicentre, parallel group, prespecified 10-year analysis, Outcomes obtained through record linkage from national registries
- Open-label
- Multicentre
- Parallel group
- Prespecified 10-year analysis
- Outcomes obtained through record linkage from national registries
Primary result
As reported in the abstract
median 10.0 years
Hazard ratio
0.79
95% CI 0.63–0.99
P = 0.044
Events by treatment group
CCTA vs Standard care
HR 0.79 (95% CI 0.63–0.99); P = 0.044
Further findings
| Outcome | CCTA | Standard care | Estimate | P value | |
|---|---|---|---|---|---|
| Non-fatal MI | 4.3% | 6.0% | HR 0.72 (CI 0.55–0.94) | P = 0.017 | |
| MACE | 8.3% | 10.3% | HR 0.80 (CI 0.65–0.97) | P = 0.026 | |
| Coronary revascularisation procedures | 15.2% | 15.3% | HR 1.00 (CI 0.86–1.17) | P = 0.99 | |
| Preventive therapy prescribing | 55.9% | 49.0% | OR 1.17 (95% CI 1.01–1.36) | P = 0.034 | |
| 0.512Ratio (log scale) |
- Preventive therapy prescribing: of 1486 vs 1485 patients with available data
All-cause, CV and CHD death; non-fatal stroke
- Similar between the groups
- P > 0.05 for all
Original publication
Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland. Lancet. Published 25 January 2025. doi:10.
Summarised from the published abstract; every number is checked against it