{"id":"9a38deb81b65","type":"article","url":"https://hartvaat.nl/2019/10/22/ccta-geleide-therapie-verbetert-uitkomsten-bij-stabiele-pijn-op-de-borst/","title":"CCTA-geleide therapie verbetert uitkomsten bij stabiele pijn op de borst","title_en":"Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog","huisarts"],"tags":[],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.07.085","source_url":"https://doi.org/10.1016/j.jacc.2019.07.085","authors":["Philip D Adamson","Michelle C Williams","Marc R Dweck","Nicholas L Mills","Nicholas A Boon","Marwa Daghem","Rong Bing","Alastair J Moss","Kenneth Mangion","Marcus Flather","John Forbes","Amanda Hunter","John Norrie","Anoop S V Shah","Adam D Timmis","Edwin J R van Beek","Amir A Ahmadi","Jonathon Leipsic","Jagat Narula","David E Newby","Giles Roditi","David A McAllister","Colin Berry"],"significance":7,"published":"2019-10-22","source_date":"2019-10-22","image":"","kennis":["https://hartvaat.nl/kennis/cardiometabool/cardiometabool-spreekuur/"],"congress":"","summary_en":"This SCOT-HEART analysis confirmed that coronary CT angiography-guided therapy improves outcomes in patients with stable chest pain by enabling earlier initiation of preventive treatments based on anatomical disease identification.","created":"2026-07-03T10:28:13Z","updated":"2026-07-03T13:27:24Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Studie die aantoont dat CCTA-geleide therapie de uitkomsten verbetert bij patiënten met stabiele pijn op de borst.","abstract_original":"BACKGROUND: Within the SCOT-HEART (Scottish COmputed Tomography of the HEART Trial) trial of patients with stable chest pain, the use of coronary computed tomography angiography (CTA) reduced the rate of death from coronary heart disease or nonfatal myocardial infarction (primary endpoint). OBJECTIVES: This study sought to assess the consistency and mechanisms of the 5-year reduction in this endpoint. METHODS: In this open-label trial, 4,146 participants were randomized to standard care alone or standard care plus coronary CTA. This study explored the primary endpoint by symptoms, diagnosis, coronary revascularizations, and preventative therapies. RESULTS: Event reductions were consistent across symptom and risk categories (p = NS for interactions). In patients who were not diagnosed with angina due to coronary heart disease, coronary CTA was associated with a lower primary endpoint incidence rate (0.23; 95% confidence interval [CI]: 0.13 to 0.35 vs. 0.59; 95% CI: 0.42 to 0.80 per 100 patient-years; p < 0.001). In those who had undergone coronary CTA, rates of coronary revascularization were higher in the first year (hazard ratio [HR]: 1.21; 95% CI: 1.01 to 1.46; p = 0.042) but lower beyond 1 year (HR: 0.59; 95% CI: 0.38 to 0.90; p = 0.015). Patients assigned to coronary CTA had higher rates of preventative therapies throughout follow-up (p < 0.001 for all), with rates highest in those with CT-defined coronary artery disease. Modeling studies demonstrated the plausibility of the observed effect size. CONCLUSIONS: The beneficial effect of coronary CTA on outcomes is consistent across subgroups with plausible underlying mechanisms. Coronary CTA improves coronary heart disease outcomes by enabling better targeting of preventative treatments to those with coronary artery disease. (Scottish COmputed Tomography of the HEART Trial [SCOT-HEART]; NCT01149590)."}