SCOT-HEART
Scottish COmputed Tomography of the HEART trial
Patient / Population Intervention / Exposition Vergleich Endpunkt
In 4,146 patients with stable chest pain, adding CT coronary angiography reduced 5-year coronary death or non-fatal MI compared with standard care alone.
N
4.146
Design
Multicentre open-label pragmatic RCT
Endpunkt
Death from coronary heart disease or non-fatal MI at 5 years
Relevanz
2
ErgebnisCTA plus standard care 2.3% vs standard care 3.9% (HR 0.59, 95% CI 0.41-0.84, P=0.004) at 5 years, without a significant increase in invasive angiography or revascularisation.
SCOT-HEART Investigators. N Engl J Med. 2018;379(10):924-33. 10.1056/NEJMoa1805971
Diskussion & Kritik
Absolute event numbers small (129 total) and benefit largely attributed to increased preventive therapy rather than more revascularisation. Underpinned guideline shifts (NICE, ESC 2019) favouring CT coronary angiography first-line in stable chest pain.