Key result
Adding coronary CTA to standard care significantly reduced 5-year death from coronary heart disease or nonfatal myocardial infarction compared to standard care alone (2.3% vs 3.9%; HR 0.59; P=0.004).
Why the study?
Does the addition of coronary CTA to standard care reduce the 5-year risk of death from coronary heart disease or nonfatal myocardial infarction in patients with stable chest pain?
Population
4,146 patients with stable chest pain who had been referred to a cardiology clinic for evaluation
Comparison
Coronary computed tomographic angiography in… vs Standard care alone
Design
RCT, Randomly assigned in a parallel-group design, Open-label
Follow-up
Median 4.8 years (range 3 to 7 years)
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Supports routine coronary CTA in stable chest pain; extends prior evidence to 5-year hard endpoints.
RCT (n=4,146)
open-label
parallel-group
Yes
Does the addition of coronary CTA to standard care reduce the 5-year risk of death from coronary heart disease or nonfatal myocardial infarction in patients with stable chest pain?
Hazard Ratio: 0.59 (95% CI 0.41–0.84)
Absolute Event Rate: 2.3% vs 3.9%
p-value: p=0.004
The routine use of coronary CTA in patients with stable chest pain significantly reduces the 5-year risk of coronary heart disease death or nonfatal myocardial infarction, likely driven by the increased initiation of appropriate preventive therapies.
A 2018 study conducted an RCT in stable chest pain (n=4,146). Coronary computed tomographic angiography (CTA) plus standard care vs. Standard care alone was evaluated on Death from coronary heart disease or nonfatal myocardial infarction at 5 years (HR 0.59, 95% CI 0.41 to 0.84, p=0.004). Adding coronary CTA to standard care significantly reduced 5-year death from coronary heart disease or nonfatal myocardial infarction compared to standard care alone (2.3% vs 3.9%; HR 0.59; P=0.004).
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