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31 Aug 18. SCOT-HEART findings

Coronary CT Angiography and 5-Year Risk of Myocardial Infarction.

The five-year update to the SCOT-HEART multicentre trial, which analysed coronary computed tomography angiography (CTA) in patients with suspected angina due to coronary heart disease has reported that CTA in combination with standard care for stable chest pain, may reduce death rates from future myocardial infarctions.

The update, presented at the European Society of Cardiology (ESC) 2018 Congress last weekend by Professor David Newby, reported significant improvements in future cardiovascular risks, in patients at risk for chronic angina initially referred for CTA plus standard care, versus those only referred to standard care.

The trial  randomly assigned 4,146 patients with stable chest pain who had been referred to a cardiology clinic for evaluation to either standard care plus CTA (2073 patients) or to standard care alone (2073 patients). Investigations, treatments, and clinical outcomes were assessed over 3 to 7 years of follow-up. The median duration of follow-up was 4.8 years, which yielded 20,254 patient-years of follow-up.

 

The beauty of the SCOT-HEART trial is the whole country’s electronic health records are kept and updated together.

Professor David NewbyBHF John Wheatley Chair of Cardiology

 

The team concluded that CTA in addition to standard care resulted in significantly lower rates of death from coronary heart disease or nonfatal myocardial infarction at 5 years than lone standard care. The supplemental procedure was also proven to not result in significantly greater risks for coronary angiography or revascularization in that time period.

 

The bottom line for me is, if you’re being tested for heart disease, get a CT. Physicians should focus on getting the right patient on the right treatment.

Professor David NewbyBHF John Wheatley Chair of Cardiology