SCOT-HEART
Scottish COmputed Tomography of the HEART trial
Patient / Population Intervention / Exposition Comparaison Critère de jugement
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
Schéma
Multicentre open-label pragmatic RCT
Critère
Death from coronary heart disease or non-fatal MI at 5 years
Pertinence
2
RésultatCTA 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
Discussion et critique
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.