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Comment
. 2020 Sep 1;93(1113):20190763.
doi: 10.1259/bjr.20190763. Epub 2019 Oct 31.

SCOT-HEART trial: reshuffling our approach to stable ischemic heart disease

Sagar B Amin  1 , Arthur E Stillman  1
Affiliations
Comment

SCOT-HEART trial: reshuffling our approach to stable ischemic heart disease

Sagar B Amin et al. Br J Radiol. .

Abstract

The role of diagnostic testing in triaging patients with stable ischemic heart disease continues to evolve towards recognizing the benefits of coronary CT angiography (CCTA) over functional testing. The SCOT-HEART (Scottish Computed Tomography of the HEART) trial highlights this paradigm shift finding a significant reduction of death from coronary heart disease or non-fatal myocardial infarction without a significant increased rate of invasive coronary angiography over a 5 year follow-up period when implementing CCTA with standard care vs standard care alone. The better negative predictive value and ability to identify nonobstructive coronary artery disease to optimize medical therapy highlight the benefits of a CCTA first strategy. With the advent of noninvasive fractional flow reserve (FFR) and widespread availability and ease of CT, CCTA continues to establish itself as a pivotal diagnostic exam for patients with stable ischemic heart disease. In this commentary, we review the SCOT-HEART trial and its impact on CCTA for patients with stable ischemic heart disease.

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References

    1. Neglia D, Rovai D, Caselli C, Pietila M, Teresinska A, Aguadé-Bruix S, et al. . Detection of significant coronary artery disease by noninvasive anatomical and functional imaging. Circ Cardiovasc Imaging 2015; 8. doi: 10.1161/CIRCIMAGING.114.002179 - DOI - PubMed
    1. Newby DE, Adamson PD, Berry C, Boon NA, Dweck MR, Flather M, et al. . Coronary CT angiography and 5-year risk of myocardial infarction. N Engl J Med 2018; 379: 924–33. doi: 10.1056/NEJMoa1805971 - DOI - PubMed
    1. .SCOT-HEART investigators Ct coronary angiography in patients with suspected angina due to coronary heart disease (SCOT-HEART): an open-label, parallel-group, multicentre trial. Lancet 2015; 385: 2383–91. doi: 10.1016/S0140-6736(15)60291-4 - DOI - PubMed
    1. Douglas PS, Hoffmann U, Patel MR, Mark DB, Al-Khalidi HR, Cavanaugh B, et al. . Outcomes of anatomical versus functional testing for coronary artery disease. N Engl J Med 2015; 372: 1291–300. doi: 10.1056/NEJMoa1415516 - DOI - PMC - PubMed
    1. Carrabba N, Migliorini A, Pradella S, Acquafresca M, Guglielmo M, Baggiano A, et al. . Old and new NICE guidelines for the evaluation of new onset stable chest pain: a real world perspective. Biomed Res Int 2018; 2018: 1–7. doi: 10.1155/2018/3762305 - DOI - PMC - PubMed