Trial reportJournal of the American College of Cardiology2019
Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain.
Trial report in Journal of the American College of Cardiology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT01149590 (Role of Multidetector Computed Tomography in the Diagnosis and Management of Patients Attending a Rapid Access Chest Pain Clinic), which is not on this map. Cited by 53 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Role of Multidetector Computed Tomography in the Diagnosis and Management of Patients Attending a Rapid Access Chest Pain Clinic
Who cites it
53 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Understanding Myocardial Infarction with Non-Obstructive Coronary Arteries (MINOCA): a comprehensive meta-analysis of clinical characteristics, management, and prognosis compared to MI with the Obstructive Coronary Artery (MIOCA).BMC cardiovascular disorders · 2025Pooled it
- Prognostic value of coronary computed tomography angiographic derived fractional flow reserve: a systematic review and meta-analysis.Heart (British Cardiac Society) · 2022Pooled it
- SCCT 2021 Expert Consensus Document on Coronary Computed Tomographic Angiography: A Report of the Society of Cardiovascular Computed Tomography.Journal of cardiovascular computed tomographyGuideline
- Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials.European heart journal · 2025Trial
- Economic Outcomes With Precision Diagnostic Testing Versus Usual Testing in Stable Chest Pain: Results From the PRECISE Randomized Trial.Circulation. Cardiovascular quality and outcomes · 2025Trial
- Validation of European Society of Cardiology pre-test probabilities for obstructive coronary artery disease in suspected stable angina.European heart journal. Quality of care & clinical outcomes · 2020Trial
- Repositioning of exercise treadmill testing in contemporary chest pain management.The international journal of cardiovascular imaging · 2026Review
- CAPIRE score predicts long-term major cardiac events.The international journal of cardiovascular imaging · 2026Article
- Coronary plaque burden and composition in an ESC guideline-selected outpatient CCTA cohort: age- and sex-specific percentile distributions.Clinical research in cardiology : official journal of the German Cardiac Society · 2026Article
- CAPIRE score in suspected coronary artery disease: predicting spontaneous events or downstream revascularization?The international journal of cardiovascular imaging · 2026Article
- From image to action: Evaluating the translation of coronary CT angiography findings into cardiovascular prevention in the emergency department.American journal of preventive cardiology · 2026Article
- Coronary CT angiography evaluation with artificial intelligence for individualized medical treatment of atherosclerosis: a Consensus Statement from the QCI Study Group.Nature reviews. Cardiology · 2026Review
- Fractional Flow Reserve from Coronary CT: Evidence, Applications, and Future Directions.Journal of cardiovascular development and disease · 2025Review
- Age-stratified differences in coronary artery plaque phenotypes in women and men with non-obstructive coronary artery disease.Open heart · 2025Article
- What role for cardiac imaging in chronic coronary syndromes: review of the literature in light of the latest recommendations.European heart journal. Imaging methods and practice · 2025Review
- The role of cardiac imaging in the post-ISCHEMIA world.The British journal of radiology · 2025Review
- Incremental value of coronary computed tomography angiography in addition to invasive coronary angiography in MINOCA.The international journal of cardiovascular imaging · 2025Article
- Clinical likelihood models calibrated against observed obstructive coronary artery disease on computed tomography angiography.European heart journal. Cardiovascular Imaging · 2025Article
- Type 2 myocardial infarction: challenges in diagnosis and treatment.European heart journal · 2025Review
- Comparison of coronary CT angiography and invasive coronary angiography results.Irish journal of medical science · 2024Article
Corrections and comments
- Commented on by
Authors and funding
24 authors.
Funding
Abstract
backgroundWithin the SCOT-HEART (Scottish COmputed Tomography of the HEART Trial) trial of patients with stable chest pain, the use of coronary computed tomography angiography (CTA) reduced the rate of death from coronary heart disease or nonfatal myocardial infarction (primary endpoint).
objectivesThis study sought to assess the consistency and mechanisms of the 5-year reduction in this endpoint.
methodsIn this open-label trial, 4,146 participants were randomized to standard care alone or standard care plus coronary CTA. This study explored the primary endpoint by symptoms, diagnosis, coronary revascularizations, and preventative therapies.
resultsEvent reductions were consistent across symptom and risk categories (p = NS for interactions). In patients who were not diagnosed with angina due to coronary heart disease, coronary CTA was associated with a lower primary endpoint incidence rate (0.23; 95% confidence interval [CI]: 0.13 to 0.35 vs. 0.59; 95% CI: 0.42 to 0.80 per 100 patient-years; p < 0.001). In those who had undergone coronary CTA, rates of coronary revascularization were higher in the first year (hazard ratio [HR]: 1.21; 95% CI: 1.01 to 1.46; p = 0.042) but lower beyond 1 year (HR: 0.59; 95% CI: 0.38 to 0.90; p = 0.015). Patients assigned to coronary CTA had higher rates of preventative therapies throughout follow-up (p < 0.001 for all), with rates highest in those with CT-defined coronary artery disease. Modeling studies demonstrated the plausibility of the observed effect size.
conclusionsThe beneficial effect of coronary CTA on outcomes is consistent across subgroups with plausible underlying mechanisms. Coronary CTA improves coronary heart disease outcomes by enabling better targeting of preventative treatments to those with coronary artery disease. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590).
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.