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The SCOT-HEART trial is one of two new studies designed to examine the role of coronary computed tomographic angiography (CCTA) in evaluating patients with suspected coronary heart disease. The trial involved 4146 patients in Scotland with stable chest pain who were referred by primary care physicians to dedicated cardiology chest pain clinics. During initial evaluation, nearly all patients underwent exercise stress testing (without imaging), and additionally, they were randomized to undergo CCTA (within 14 days) or no CCTA. Clinicians were permitted to order stress imaging tests regardless of randomized group; these were scheduled for one third of patients in each group.
The primary endpoint was “certainty of the diagnosis of angina seconda…