Active not recruitingNAINTERVENTIONAL

Computed Tomography Coronary Angiography for the Prevention of Myocardial Infarction (The SCOT-HEART 2 Trial)

The SCOT-HEART 2 study is investigating new ways to prevent heart attacks. Currently, doctors often use a 'risk score' to decide if someone needs treatment to prevent heart disease. This study wants to see if a special heart scan, called a CT coronary angiography (CTCA), which gives detailed pictures of your heart's arteries, can do a better job. The researchers believe that using this scan to guide treatment might reduce the chances of future heart attacks or heart-related deaths more effectively than the current methods. They are comparing these two approaches in people aged 40 to 70 across Scotland who have certain risk factors for heart disease.

At a glance

Status

Active not recruiting

Phase

Sponsor

University of Edinburgh

Enrolment target

6,139

Start

13 Jan 2020

Estimated completion

31 Dec 2028

Cardiovascular Diseases

What is this study about?

Heart disease is a common problem, and doctors are always looking for the best ways to prevent serious events like heart attacks. Currently, when doctors decide if someone needs preventative treatment (like medicines), they often use a calculated 'risk score'. This score estimates your chances of developing heart disease in the future. However, these scores aren't always perfect; sometimes they recommend treatment for people who might not need it, or they miss people who would benefit.

This study is looking at a different approach. Researchers want to see if using a special scan called a CT coronary angiography (CTCA) can be more helpful. A CTCA is like a detailed X-ray that takes pictures of the arteries around your heart. It can show if there's any narrowing or blockages that might lead to problems later on. Previous research has suggested that using this scan can help doctors make better decisions about treatment, which could lead to fewer heart attacks.

The SCOT-HEART 2 study aims to compare these two methods directly: using the standard risk score versus using the CTCA scan. The goal is to see if guiding your care based on the CTCA scan helps doctors target treatments more accurately, avoid giving too much medicine to people who don't need it, and ultimately, significantly reduce the number of heart attacks and other heart problems in the future. This could lead to a better way to prevent heart disease for many people.

Key takeaways

The study compares two ways to prevent heart attacks: using a special scan (CTCA) versus standard risk scores.
It aims to see if the CTCA scan can lead to more effective and targeted prevention.
Participants must be 40-70 years old, live in Scotland, and have heart disease risk factors.
It helps doctors understand the best way to prevent heart disease for future patients.
Your medical care will not be affected if you choose not to participate or decide to leave the study.

Who may be eligible?

To join this study, you need to be living in Scotland and be between 40 and 70 years old. You also need to have at least one risk factor for heart disease. These risk factors could include being over 60, currently smoking or having smoked recently, having high blood pressure or high cholesterol, having diabetes, or certain conditions like rheumatoid arthritis.

There are also reasons why you might not be able to join. For example, if you can't have a CT scan for any reason, or if you already know you have heart disease or a major problem with your blood vessels. You also can't take part if you've already had a heart scan in the last five years, or if you have severe kidney disease.

The study also excludes people who have a rare serious inherited cholesterol problem, can't take statin medicines, or have been taking statins for more than two years. If you've had a specific type of heart scan before that showed high risk, you also won't be able to participate.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you between 40 and 70 years old?
Do you live in Scotland and have a Community Health Index (CHI) number?
Do you have at least one risk factor for heart disease (e.g., high blood pressure, high cholesterol, smoking, diabetes)?
Have you NOT had a heart scan in the last 5 years?
Do you NOT currently have known heart disease or major blood vessel problems?

Answer every question to see your result.

What does participation involve?

If you join the study, you'll be randomly assigned to one of two groups, like flipping a coin. One group will have their care guided by a CT coronary angiography (CTCA) scan, and the other group will have their care guided by the usual risk scores. You will attend appointments for these assessments and any follow-up needed. The study will track your health over several years to see how effective each approach is in preventing heart problems. The total duration of your participation, including follow-up, will be determined by the study design but usually involves periodic checks on your health over an extended period.

Potential risks and benefits

Potential benefits of taking part include contributing to important research that could improve how we prevent heart disease for future patients. If you are in the CTCA group, the scan might detect early signs of heart problems, allowing for more targeted treatment. As with all medical procedures, there are potential risks associated with the CTCA scan, such as exposure to a small amount of radiation, though every effort is made to keep this to a minimum. You have the right to withdraw from the study at any time without giving a reason, and it will not affect your usual medical care.

Locations (1)

Some site locations are approximate. We're improving this — please verify with the trial team before travelling.

Western General Hospital
Verified postcode
Edinburgh, United Kingdom

Common questions

What is a CT coronary angiography (CTCA)?

It's a special type of X-ray scan that takes detailed pictures of the arteries surrounding your heart, helping doctors see if there are any blockages or narrowing.

What is a 'risk score' for heart disease?

A risk score is a calculation doctors use, based on different health factors, to estimate your chances of developing heart disease in the future.

Why are you doing this study?

We want to find out if using a CTCA scan to guide treatment for heart disease prevention is more effective than the current standard methods, leading to fewer heart attacks.

Will I definitely get the CTCA scan if I join?

No, you will be randomly assigned to either receive care guided by the CTCA scan or care guided by the standard risk score. It's like flipping a coin.

What kind of treatments might be offered?

This study doesn't recommend specific treatments. However, if problems are found, it might lead to discussions with your doctor about lifestyle changes or medications to help manage your heart health.