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Angina PectorisSCOT-HEARTNCT01149590

Scottish COmputed Tomography of the HEART Trial

A study testing Computer Tomography Angiography in people with Angina Pectoris and Coronary Heart Disease, run by University of Edinburgh at 12 sites in United Kingdom.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

The primary objective of the study is to see if coronary artery calcium score and computed tomography coronary angiogram alters the proportion of patients diagnosed with angina due to coronary heart disease. Read more about this study

Who is it for?
Ages 18 to 75 years
Conditions the study is for
Angina Pectoris, Coronary Heart Disease
What is being tested?
Computer Tomography Angiography
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
4,138 participants
Where
12 sitesUnited Kingdom
Study dates
Nov 2010to May 2015
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 to 75 years
  • All sexes
  • No healthy volunteers
  • Adult, Older adult

Who may be able to join

  • 18 and ≤75 years of age
  • Attendance at the Rapid Access Chest Pain Clinic

Who cannot join

  • Inability or unwilling to undergo computed tomography scanning, such as exceeding weight tolerance of scanner
  • Severe renal failure (serum creatinine >200 µmol/L or estimated glomerular filtration rate <30 mL/min)
  • Previous recruitment to the trial
  • Major allergy to iodinated contrast agent
  • Unable to give informed consent
  • Known pregnancy
  • Acute coronary syndrome within 3 months

Trial locations and contacts

12 sites in 1 country.

12 sites in 1 country

United Kingdom12 sites

  • University Hospital Ayr

    Ayr, KA6 6DS

  • Ninewells Hospital

    Dundee, Tayside, DD1 9SY

  • Royal Infirmary Edinburgh

    Edinburgh, EH16 4SB

  • Western General Hospital

    Edinburgh, EH4 2XU

  • Western Infirmary Glasgow

    Glasgow, G11 6NT

  • Glasgow Royal Infirmary

    Glasgow, G31 2ER

  • Victoria Hospital

    Kirkcaldy, Fife, KY2 5AH

  • Forth Valley Royal

    Larbert, FK5 4RW

  • St John's Hosptial

    Livingston, EH54 6PP

  • Borders General Hospital

    Melrose, Borders, TD6 9BS

  • Royal Alexandra Hospital

    Paisley, PA2 9PN

  • Perth Royal Infirmary

    Perth, PH1 1NX

Other trials in United Kingdom

About this study

Official title: Role of Multidetector Computed Tomography in the Diagnosis and Management of Patients Attending a Rapid Access Chest Pain Clinic

The primary objective of the study is to see if coronary artery calcium score and computed tomography coronary angiogram alters the proportion of patients diagnosed with angina due to coronary heart disease.

Read the detailed description

Rapid access chest pain clinics have facilitated the early diagnosis and treatment of patients with coronary heart disease and angina. Despite this important service provision, coronary heart disease continues to be under-diagnosed and many patients are left untreated and at risk. Recent advances in imaging technology have now led to the widespread use of non-invasive computed tomography both to measure coronary artery calcium scores and undertake coronary angiography. However, this technology has not been robustly evaluated in any systematic approach. Using state-of-the-art multidetector computed tomography scanners, we propose to undertake a major multicentre randomized controlled trial to assess the added value of computed tomography imaging in over 4000 patients attending rapid access chest pain clinics across Scotland. This will define the most appropriate use of this emerging technology in the setting of diagnosing and treating patients with coronary heart disease and angina pectoris. This study will also lay the foundation for future studies to look at the potential prognostic value of this technology.

Being tested
Computer Tomography Angiography
Keywords
Angina, Coronary Heart Disease, Computed Tomography, Angiogram, Coronary Artery Calcium Score, Chest Pain, Angina Pectoris due to Coronary Heart Disease
Medical subject headings
Angina Pectoris, Coronary Disease, Chest Pain

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • Computer Tomography AngiographyProcedure or surgery

    Computed Tomography Angiography

Study groups in NCT01149590
Study groupRoleWhat they receive
CT Calcium Score & Coronary AngiographyExperimentalCT Scan
Receives: Procedure: Computer Tomography Angiography
No CT ScanNo interventionNo CT Scan

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Proportion of patients diagnosed with angina pectoris secondary to coronary heart disease

    Measured: 6 weeks

Secondary outcomes (5)

  1. Symptoms

    (i) Chest pain. (ii) Quality of life.

    Measured: Baseline, after computed tomography scan (where appropriate), 6 weeks and 6 months

  2. Diagnosis

    (i) Diagnosis and severity of coronary heart disease (ii) Accuracy of computed tomography coronary angiography

    Measured: Baseline, after computed tomography scan (where appropriate), 6 weeks and 6 months

  3. Investigations

    (i) Exercise electrocardiographic stress test (ii) Nuclear medicine imaging - myocardial perfusion imaging (iii) Stress echocardiography (iv) Invasive coronary angiography (v) Non-coronary investigations

    Measured: Baseline, 6 weeks, 6 months

  4. Treatment

    (i) Secondary prevention (ii) Pharmacological anti-anginal therapy (iii) Coronary revascularisation

    Measured: Baseline, after computed tomography scan (where appropriate), 6 weeks, 6 months

  5. Long-term outcome

    (i) Coronary heart disease death or non-fatal Myocardial Infarction (MI) (ii) Coronary heart disease death (iii) Non-fatal MI (iv) Coronary heart disease death, non-fatal MI or non-fatal stroke (v) Non-fatal stroke (vi) All-cause death (vii) Cardiovascular death (viii) Coronary revascularisation; percutaneous coronary intervention or coronary artery bypass graft surgery (ix) Hospitalisation for chest pain including acute coronary syndromes and non-coronary chest pain (x) Hospitalisation for cardiovascular disease including coronary artery disease, cerebrovascular disease and peripheral arterial disease

    Measured: 10 years

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted23 Jun 2010 (estimated)
  2. Study startNov 2010
  3. Primary completionMay 2015
  4. Study completionMay 2015

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Diagnosis
Allocation
Randomised
Intervention model
Parallel groups
Masking
None (open label)
Enrolment
4,138 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT01149590
Sponsor's protocol ID
CZH/4/588
Acronym
SCOT-HEART
Status last verified
Apr 2017
First submitted
21 Jun 2010
Last updated
3 Jun 2024
Results posted
No
Data monitoring committee
No
Individual data sharing
Yes: Please contact corresponding author

Publications

  • Newby DE, Williams MC, Flapan AD, Forbes JF, Hargreaves AD, Leslie SJ, Lewis SC, McKillop G, McLean S, Reid JH, Sprat JC, Uren NG, van Beek EJ, Boon NA, Clark L, Craig P, Flather MD, McCormack C, Roditi G, Timmis AD, Krishan A, Donaldson G, Fotheringham M, Hall FJ, Neary P, Cram L, Perkins S, Taylor F, Eteiba H, Rae AP, Robb K, Barrie D, Bissett K, Dawson A, Dundas S, Fogarty Y, Ramkumar PG, Houston GJ, Letham D, O'Neill L, Pringle SD, Ritchie V, Sudarshan T, Weir-McCall J, Cormack A, Findlay IN, Hood S, Murphy C, Peat E, Allen B, Baird A, Bertram D, Brian D, Cowan A, Cruden NL, Dweck MR, Flint L, Fyfe S, Keanie C, MacGillivray TJ, Maclachlan DS, MacLeod M, Mirsadraee S, Morrison A, Mills NL, Minns FC, Phillips A, Queripel LJ, Weir NW, Bett F, Divers F, Fairley K, Jacob AJ, Keegan E, White T, Gemmill J, Henry M, McGowan J, Dinnel L, Francis CM, Sandeman D, Yerramasu A, Berry C, Boylan H, Brown A, Duffy K, Frood A, Johnstone J, Lanaghan K, MacDuff R, MacLeod M, McGlynn D, McMillan N, Murdoch L, Noble C, Paterson V, Steedman T, Tzemos N. Role of multidetector computed tomography in the diagnosis and management of patients attending the rapid access chest pain clinic, The Scottish computed tomography of the heart (SCOT-HEART) trial: study protocol for randomized controlled trial. Trials. 2012 Oct 4;13:184. doi: 10.1186/1745-6215-13-184.

    PubMed 23036114

  • 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 Jun 13;385(9985):2383-91. doi: 10.1016/S0140-6736(15)60291-4. Epub 2015 Mar 15.

    PubMed 25788230

  • SCOT-HEART Investigators; Newby DE, Adamson PD, Berry C, Boon NA, Dweck MR, Flather M, Forbes J, Hunter A, Lewis S, MacLean S, Mills NL, Norrie J, Roditi G, Shah ASV, Timmis AD, van Beek EJR, Williams MC. Coronary CT Angiography and 5-Year Risk of Myocardial Infarction. N Engl J Med. 2018 Sep 6;379(10):924-933. doi: 10.1056/NEJMoa1805971. Epub 2018 Aug 25.

    PubMed 30145934

  • Chen J, Sanchez LE, Dewey M, Rudd JHF, Newby DE, Williams MC, Weir-McCall JR. Prognostic Value of AI-derived Ventricular Imaging Phenotypes from Cardiac CTA for Long-term Risk of Myocardial Infarction ---Analysis of SCOT-HEART Trial. Eur Heart J Cardiovasc Imaging. 2026 Sep 10:jeag252. doi: 10.1093/ehjci/jeag252. Online ahead of print.

    PubMed 42721291

  • Guimaraes AR, Williams SE, Macmillan MT, Wood K, Wang C, Weir-McCall JR, Adamson PD, Roditi G, Mills NL, Dweck MR, Dewey M, Wasserthal J, Slomka PJ, Dey D, Newby DE, Williams MC. Machine Learning Multiorgan Analysis of Coronary CT Angiography Body Composition, Myocardial Infarction, and Mortality in the SCOT-HEART Trial. Radiology. 2026 Jun;319(3):e251821. doi: 10.1148/radiol.251821.

    PubMed 42377128

  • Rasmussen LD, Sikjaer M, Soby JH, Pedersen OB, Westra J, Efthekhari A, Christiansen EH, Foldyna B, Williams MC, Dweck MR, Newby DE, Douglas PS, Bottcher M, Winther S. Dual probability approach for risk adjustment in patients with a low clinical likelihood of coronary artery disease. Eur Heart J Cardiovasc Imaging. 2025 Aug 29;26(9):1507-1517. doi: 10.1093/ehjci/jeaf193.

    PubMed 40590244

  • Williams MC, Wereski R, Tuck C, Adamson PD, Shah ASV, van Beek EJR, Roditi G, Berry C, Boon N, Flather M, Lewis S, Norrie J, Timmis AD, Mills NL, Dweck MR, Newby DE; SCOT-HEART Investigators. Coronary CT angiography-guided management of patients with stable chest pain: 10-year outcomes from the SCOT-HEART randomised controlled trial in Scotland. Lancet. 2025 Jan 25;405(10475):329-337. doi: 10.1016/S0140-6736(24)02679-5.

    PubMed 39863372

  • Kolossvary M, Lin A, Kwiecinski J, Cadet S, Slomka PJ, Newby DE, Dweck MR, Williams MC, Dey D. Coronary Plaque Radiomic Phenotypes Predict Fatal or Nonfatal Myocardial Infarction: Analysis of the SCOT-HEART Trial. JACC Cardiovasc Imaging. 2025 Mar;18(3):308-319. doi: 10.1016/j.jcmg.2024.08.012. Epub 2024 Oct 30.

    PubMed 39480364

  • Williams MC, Kwiecinski J, Doris M, McElhinney P, D'Souza MS, Cadet S, Adamson PD, Moss AJ, Alam S, Hunter A, Shah ASV, Mills NL, Pawade T, Wang C, Weir-McCall JR, Bonnici-Mallia M, Murrills C, Roditi G, van Beek EJR, Shaw LJ, Nicol ED, Berman DS, Slomka PJ, Newby DE, Dweck MR, Dey D. Sex-Specific Computed Tomography Coronary Plaque Characterization and Risk of Myocardial Infarction. JACC Cardiovasc Imaging. 2021 Sep;14(9):1804-1814. doi: 10.1016/j.jcmg.2021.03.004. Epub 2021 Apr 14.

    PubMed 33865779

  • Singh T, Bing R, Dweck MR, van Beek EJR, Mills NL, Williams MC, Villines TC, Newby DE, Adamson PD. Exercise Electrocardiography and Computed Tomography Coronary Angiography for Patients With Suspected Stable Angina Pectoris: A Post Hoc Analysis of the Randomized SCOT-HEART Trial. JAMA Cardiol. 2020 Aug 1;5(8):920-928. doi: 10.1001/jamacardio.2020.1567.

    PubMed 32492104

  • Williams MC, Kwiecinski J, Doris M, McElhinney P, D'Souza MS, Cadet S, Adamson PD, Moss AJ, Alam S, Hunter A, Shah ASV, Mills NL, Pawade T, Wang C, Weir McCall J, Bonnici-Mallia M, Murrills C, Roditi G, van Beek EJR, Shaw LJ, Nicol ED, Berman DS, Slomka PJ, Newby DE, Dweck MR, Dey D. Low-Attenuation Noncalcified Plaque on Coronary Computed Tomography Angiography Predicts Myocardial Infarction: Results From the Multicenter SCOT-HEART Trial (Scottish Computed Tomography of the HEART). Circulation. 2020 May 5;141(18):1452-1462. doi: 10.1161/CIRCULATIONAHA.119.044720. Epub 2020 Mar 16.

    PubMed 32174130

  • Adamson PD, Williams MC, Dweck MR, Mills NL, Boon NA, Daghem M, Bing R, Moss AJ, Mangion K, Flather M, Forbes J, Hunter A, Norrie J, Shah ASV, Timmis AD, van Beek EJR, Ahmadi AA, Leipsic J, Narula J, Newby DE, Roditi G, McAllister DA, Berry C; SCOT-HEART Investigators. Guiding Therapy by Coronary CT Angiography Improves Outcomes in Patients With Stable Chest Pain. J Am Coll Cardiol. 2019 Oct 22;74(16):2058-2070. doi: 10.1016/j.jacc.2019.07.085.

    PubMed 31623764

  • Bing R, Henderson J, Hunter A, Williams MC, Moss AJ, Shah ASV, McAllister DA, Dweck MR, Newby DE, Mills NL, Adamson PD. Clinical determinants of plasma cardiac biomarkers in patients with stable chest pain. Heart. 2019 Nov;105(22):1748-1754. doi: 10.1136/heartjnl-2019-314892. Epub 2019 Jun 1.

    PubMed 31154425

  • Williams MC, Moss AJ, Dweck M, Adamson PD, Alam S, Hunter A, Shah ASV, Pawade T, Weir-McCall JR, Roditi G, van Beek EJR, Newby DE, Nicol ED. Coronary Artery Plaque Characteristics Associated With Adverse Outcomes in the SCOT-HEART Study. J Am Coll Cardiol. 2019 Jan 29;73(3):291-301. doi: 10.1016/j.jacc.2018.10.066.

    PubMed 30678759

  • Adamson PD, Hunter A, Madsen DM, Shah ASV, McAllister DA, Pawade TA, Williams MC, Berry C, Boon NA, Flather M, Forbes J, McLean S, Roditi G, Timmis AD, van Beek EJR, Dweck MR, Mickley H, Mills NL, Newby DE. High-Sensitivity Cardiac Troponin I and the Diagnosis of Coronary Artery Disease in Patients With Suspected Angina Pectoris. Circ Cardiovasc Qual Outcomes. 2018 Feb;11(2):e004227. doi: 10.1161/CIRCOUTCOMES.117.004227.

    PubMed 29444926

Questions about this trial

What is this clinical trial studying?

A study testing Computer Tomography Angiography in people with Angina Pectoris and Coronary Heart Disease, run by University of Edinburgh at 12 sites in United Kingdom.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 2 inclusion and 7 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 3 Jun 2024. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 12 sites in United Kingdom. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Proportion of patients diagnosed with angina pectoris secondary to coronary heart disease (time frame: 6 weeks). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT01149590, which also lists 22 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 3 Jun 2024.

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