Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial. Issue 13 (28th February 2017)

• Record Type: Journal Article
• Authors: Williams, Michelle C; Hunter, Amanda; Shah, Anoop; Assi, Valentina; Lewis, Stephanie; Mangion, Kenneth; Berry, Colin; Boon, Nicholas A; Clark, Elizabeth; Flather, Marcus; Forbes, John; McLean, Scott; Roditi, Giles; van Beek, Edwin JR; Timmis, Adam D; Newby, David E
• Other Names: author non-byline.; Williams Michelle author non-byline.; Pawade Tania author non-byline.; Flapan Andrew author non-byline.; Hargreaves Allister author non-byline.; Leslie Stephen author non-byline.; McKillop Graham author non-byline.; Reid John author non-byline.; Spratt James author non-byline.; Uren Neal author non-byline.; Craig Peter author non-byline.; Barlow Tom author non-byline.; McCormack Chiara author non-byline.; Shepherd Susan author non-byline.; Bucukoglu Marise author non-byline.; Parker Richard author non-byline.; Krishan Ashma author non-byline.; Wee Fiona author non-byline.; Wackett Anthony author non-byline.; Walker Allan author non-byline.; Milne Lynsey author non-byline.; Oatey Kat author non-byline.; Neary Paul author non-byline.; Donaldson Gillian author non-byline.; Fairbairn Terry author non-byline.; Fotheringham Marlene author non-byline.; Hall Fiona author non-byline.; Glen Stephen author non-byline.; Perkins Sarah author non-byline.; Taylor Fiona author non-byline.; Cram Louisa author non-byline.; Beveridge Catherine author non-byline.; Cairns Avril author non-byline.; Dougherty Frances author non-byline.; Eteiba Hany author non-byline.; Rae Alan author non-byline.; Robb Kate author non-byline.; Crawford Wenda author non-byline.; Clarkin Patricia author non-byline.; Lennon Elisabeth author non-byline.; Houston Graeme author non-byline.; Pringle Stuart author non-byline.; Prasad Guntur Ramkumar author non-byline.; Sudarshan Thiru author non-byline.; Fogarty Yvonne author non-byline.; Barrie Dawn author non-byline.; Bissett Kim author non-byline.; Dawson Adelle author non-byline.; Dundas Scott author non-byline.; Letham Deborah author non-byline.; O'Neill Linda author non-byline.; Ritchie Valerie author non-byline.; Weir-McCall Jonathan author non-byline.; Dougall Hamish author non-byline.; Ahmed Faheem author non-byline.; Cormack Alistair author non-byline.; Findlay Iain author non-byline.; Hood Stuart author non-byline.; Murphy Clare author non-byline.; Peat Eileen author non-byline.; McCabe Lynne author non-byline.; McCubbin Margaret author non-byline.; Allen Barbara author non-byline.; Behan Miles author non-byline.; Bertram Danielle author non-byline.; Brian David author non-byline.; Cowan Amy author non-byline.; Cruden Nicholas author non-byline.; Denvir Martin author non-byline.; Dweck Marc author non-byline.; Flint Laura author non-byline.; Fyfe Samantha author non-byline.; Grubb Neil author non-byline.; Keanie Collette author non-byline.; Lang Chris author non-byline.; MacGillivray Tom author non-byline.; MacLachlan David author non-byline.; MacLeod Margaret author non-byline.; Mirsadraee Saeed author non-byline.; Morrison Avril author non-byline.; Mills Nicholas author non-byline.; Northridge David author non-byline.; Phillips Alyson author non-byline.; Queripel Laura author non-byline.; Weir Nicholas author non-byline.; Jacob Ashok author non-byline.; Bett Fiona author non-byline.; Divers Frances author non-byline.; Fairley Katie author non-byline.; Keegan Edith author non-byline.; White Tricia author non-byline.; Fowler Julia author non-byline.; Gemmill John author non-byline.; McGowan James author non-byline.; Henry Margo author non-byline.; Francis Mark author non-byline.; Sandeman Dennis author non-byline.; Dinnel Lorraine author non-byline.; Bloomfield Peter author non-byline.; Denvir Martin author non-byline.; Henriksen Peter author non-byline.; MacLeod Donald author non-byline.; Morrison Avril author non-byline.; Mordi Ify author non-byline.; Tzemos Nikolaos author non-byline.; Connolly Eugene author non-byline.; Boylan Heather author non-byline.; Brown Ammani author non-byline.; Farrell Lesley author non-byline.; Frood Alison author non-byline.; Glover Caroline author non-byline.; Johnstone Janet author non-byline.; Lanaghan Kirsten author non-byline.; McGlynn Deborah author non-byline.; McGregor Lorraine author non-byline.; McLennan Evonne author non-byline.; Murdoch Laura author non-byline.; Paterson Victoria author non-byline.; Teyhan Fiona author non-byline.; Teenan Marion author non-byline.; Woodward Rosie author non-byline.; Steedman Tracey author non-byline.;
• Is Part Of: Heart. Volume 103:Issue 13(2017)
• Page Start: 995
• Page End: 1001
• Publication Date: 2017-02-28
• Subjects: Heart -- Diseases -- Treatment -- Periodicals; Cardiology -- Periodicals; 616.12
• DOI: 10.1136/heartjnl-2016-310129
• Languages: English
• ISSNs: 1355-6037

Abstract

Abstract : Background: In patients with suspected angina pectoris, CT coronary angiography (CTCA) clarifies the diagnosis, directs appropriate investigations and therapies, and reduces clinical events. The effect on patient symptoms is currently unknown. Methods: In a prospective open-label parallel group multicentre randomised controlled trial, 4146 patients with suspected angina due to coronary heart disease were randomised 1:1 to receive standard care or standard care plus CTCA. Symptoms and quality of life were assessed over 6 months using the Seattle Angina Questionnaire and Short Form 12. Results: Baseline scores indicated mild physical limitation (74±0.4), moderate angina stability (44±0.4), modest angina frequency (68±0.4), excellent treatment satisfaction (92±0.2) and moderate impairment of quality of life (55±0.3). Compared with standard care alone, CTCA was associated with less marked improvements in physical limitation (difference −1.74 (95% CIs, −3.34 to −0.14), p=0.0329), angina frequency (difference −1.55 (−2.85 to −0.25), p=0.0198) and quality of life (difference −3.48 (−4.95 to −2.01), p<0.0001) at 6 months. For patients undergoing CTCA, improvements in symptoms were greatest in those diagnosed with normal coronary arteries or who had their preventative therapy discontinued, and least in those with moderate non-obstructive disease or had a new prescription of preventative therapy (p<0.001 for all). Conclusions: While improving diagnosis, treatment and outcome, CTCA is associated with a small attenuation of the improvements in symptoms and quality of life due to the detection of moderate non-obstructive coronary artery disease. Trial registration number: NCT01149590.