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More than a decade ago, investigators enrolled 4100 patients with suspected stable angina (mean age, 57) at 12 Scottish clinics in the SCOT-HEART trial (NEJM JW Gen Med May 1 2015 and Lancet 2015; 385:2383) and randomized them to receive standard care (at that time, mostly symptom-limited exercise electrocardiography) or standard care plus computed tomographic angiography (CTA). Short-term results suggested that CTA-guided management improved diagnosis, management, and outcomes.
Now, after a median 10 years' follow-up, the researchers report that coronary heart disease–related death or nonfatal myocardial infarction (MI) was less common in the CTA-guided group than in the standard-care group (6.6% vs. 8.2%), mostly due to fewer MIs (4.3% vs.…