Our SCOT-HEART & Edinburgh Imaging QMRI teams won the BMJ Imaging Team of the Year Award 2017!
The Scottish COmputed Tomography of the HEART(SCOT-HEART) Randomised Controlled Trial demonstrated that, compared to patients randomised to standard care alone, Computed Tomography Coronary Angiography (CTCA):
This led to:
The trial was published in The Lancet in 2015 with numerous further publications.
The trial is widely viewed as demonstrating the efficacy of CTCA in managing patients with suspected angina pectoris & is a flag ship of how efficient & effective trials can be conducted within the NHS service.
The Scot-Heart trial has transformed how we manage patients with suspected angina pectoris due to coronary heart disease. Computed tomography coronary angiography (CTCA) is now the first line investigation of choice for the NHS.
The team which eventually became SCOT-HEART:
NHS Lothian & the University of Edinburgh together developed our CTCA service with involvement of patients & clinicians, which is now mature & established.
This required extensive training and dedication to improve image quality whilst reducing radiation exposure.
The research environment and the attention to detail has led to extremely low radiation doses for CTCA (2-3 mSv), which is 5-fold lower than comparable institutions in North American (~10 mSv).
We designed a major multicentre, Scotland-wide, randomised controlled clinical trial to determine the effect of CTCA on diagnosis, investigation, management & ultimate clinical outcome of patients with suspected angina pectoris due to coronary heart disease (the SCOT-HEART trial).
This was funded by the Chief Scientist’s Office of the Scottish Government.
We involved clinicians in secondary care across Scotland in the design, conduct & delivery of our trial, guided by patient representatives & research funders.
We randomised 4,146 patients with suspected angina pectoris due to coronary heart disease (~40% of patients attending the clinics) from 12 Cardiology Rapid Access Chest Pain Clinics across Scotland, to standard care or standard care with CTCA.
The SCOT-HEART trial distinguished itself by its broad inclusive & generalisable study population, as well as its implementation in routine real-world clinical practice with patient-centred & clinician-centred outcomes.
The SCOT-HEART team has widely shared its clinical & research experience, having established training programmes, clinical CTCA courses & presentations at national & international meetings.
The trial has already led to changes in NICE guidance (CG95; November 2016 Update), which states that this is an extremely cost effective strategy.