CCTA routine scans prevent thousands of heart attacks, study finds

A 10-year trial found that the number of non-fatal heart attacks in the group who had a 3D imaging test of their heart, known as a coronary computed tomography angiogram (CCTA), was 28% lower compared to those who had standard tests. Applied across the UK population and the current rate of CCTA use, experts estimate that this equates to 6,000 heart attacks avoided over the past ten years. 

The results have been published in The Lancet.

University of Edinburgh researchers who led the study say this is likely due to more people in the CCTA group being prescribed preventative medicines as a result of the test. 

There are 2.3 million people in the UK living with coronary heart disease, which is caused by narrowing and blockages in the arteries that supply the heart with blood. If left untreated, coronary heart disease can lead to a heart attack. It was the second biggest killer in the UK in 2023, responsible for around 66,000 deaths – one every eight minutes. 

The study was a 10-year follow up of the initial SCOT-HEART trial, which provided evidence that led to the UK updating its guidelines in 2016 to recommended CCTA scans as one of the first tests for someone experiencing new chest pain.

The decade-long study involved more than 4,100 people across Scotland with suspected angina – chest pain due to reduced blood flow to the heart muscle – who had been referred to a chest pain clinic. Half had a CCTA scan – a non-invasive, 3D imaging test that helps determine if a heart’s arteries are narrowed or blocked – plus standard tests, and half received standard tests only. 

Early results showed that people who had CCTA scans were more likely to undergo additional procedures in the first year after their scan. By five years the number of procedures had evened out between the groups, but the CCTA group were less likely to have had a heart attack and more likely to be taking preventative drugs. At 10 years, 56% of the CCTA group were taking medicines, including aspirin and statins, to reduce their risk of a heart attack compared to 49% in the standard tests group. 

"The SCOT-HEART trial helped to change clinical practice in the UK. Our latest study is the longest follow up of CCTA scanning to-date, making it clear that the benefits for both our patients and the healthcare system are felt for many years beyond their scan. But access to CCTA scans remains variable across the country. We want to see more opportunities for testing across the UK to address this disparity, such as the community diagnostic hubs being rolled out by the NHS in England, so that more people can benefit from this game changing innovation," said Professor Michelle Williams, British Heart Foundation Intermediate Clinical Research Fellow at the University of Edinburgh. 

Professor Bryan Williams, Chief Scientific and Medical Officer at the British Heart Foundation, added: "This study is a brilliant illustration of the vital role that research plays in unlocking new ways of preventing, diagnosing and treating heart and circulatory diseases. It’s not just in the UK that SCOT-HEART has had an impact – it has driven implementation of CCTA scans globally. Thanks to the introduction of CCTA scans, which BHF funding helped to make possible, doctors can identify and treat people at risk of heart attacks at an earlier stage – before they become patients. Ultimately, this means thousands of people are living for longer in good health, and families get to spend more time with their loved ones." 

The SCOT-HEART trial and follow up studies were funded by The Chief Scientist Office of the Scottish Government Health and Social Care Directorates, Edinburgh and Lothians Health Foundation Trust, British Heart Foundation, and Heart Diseases Research Fund. 

Source: University of Edinburgh

28.01.2025

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