CT Angiography, Healthy Lifestyle Behaviors, and Preventive Therapy: A Nested Substudy of the SCOT-HEART 2 Randomized Clinical Trial
Abstract
Importance
Healthy lifestyles and uptake of primary preventive therapies for cardiovascular disease remain poor.
Objective
To determine the impact of coronary computed tomography (CT) angiography on healthy lifestyle behaviors, acceptance of recommended treatments, and modification of risk factors as compared with guideline-directed cardiovascular risk scoring.
Design, Setting, and Participants
This was a nested substudy conducted from September 2020 to August 2024 of a randomized clinical trial where participants underwent cardiovascular risk scoring or coronary CT angiography. Primary care-based screening took place in Scotland. Included in the analysis were asymptomatic individuals aged 40 to 70 years without known cardiovascular disease and with at least 1 cardiovascular risk factor. Study data were analyzed from August to September 2024.
Interventions
All participants received lifestyle advice with additional recommendations for moderate-intensity statin therapy if the 10-year cardiovascular risk was greater than or equal to 10% or combined antiplatelet and at least moderate-intensity statin therapies if coronary atherosclerosis was identified on CT angiography.
Main Outcomes and Measures
The composite primary outcome was compliance with the National Institute for Health and Care Excellence recommendations for diet, body mass index, smoking, and physical exercise at 6 months.
Results
Between September 2020 and January 2024, 400 participants were enrolled (median [IQR]…
How strong is the evidence?
Evidence Hub reads this as a randomized trial, done in people. Its evidence level is 2 of 5 (High · randomized trial). Randomized trials of a reasonable size are the strongest single-study design. Reported size: 147 participants or records.
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