@article {Williams995, author = {Michelle C Williams and Amanda Hunter and Anoop Shah and Valentina Assi and Stephanie Lewis and Kenneth Mangion and Colin Berry and Nicholas A Boon and Elizabeth Clark and Marcus Flather and John Forbes and Scott McLean and Giles Roditi and Edwin JR van Beek and Adam D Timmis and David E Newby}, editor = {, and Williams, Michelle and Pawade, Tania and Flapan, Andrew and Hargreaves, Allister and Leslie, Stephen and McKillop, Graham and Reid, John and Spratt, James and Uren, Neal and Craig, Peter and Barlow, Tom and McCormack, Chiara and Shepherd, Susan and Bucukoglu, Marise and Parker, Richard and Krishan, Ashma and Wee, Fiona and Wackett, Anthony and Walker, Allan and Milne, Lynsey and Oatey, Kat and Neary, Paul and Donaldson, Gillian and Fairbairn, Terry and Fotheringham, Marlene and Hall, Fiona and Glen, Stephen and Perkins, Sarah and Taylor, Fiona and Cram, Louisa and Beveridge, Catherine and Cairns, Avril and Dougherty, Frances and Eteiba, Hany and Rae, Alan and Robb, Kate and Crawford, Wenda and Clarkin, Patricia and Lennon, Elisabeth and Houston, Graeme and Pringle, Stuart and Prasad, Guntur Ramkumar and Sudarshan, Thiru and Fogarty, Yvonne and Barrie, Dawn and Bissett, Kim and Dawson, Adelle and Dundas, Scott and Letham, Deborah and O{\textquoteright}Neill, Linda and Ritchie, Valerie and Weir-McCall, Jonathan and Dougall, Hamish and Ahmed, Faheem and Cormack, Alistair and Findlay, Iain and Hood, Stuart and Murphy, Clare and Peat, Eileen and McCabe, Lynne and McCubbin, Margaret and Allen, Barbara and Behan, Miles and Bertram, Danielle and Brian, David and Cowan, Amy and Cruden, Nicholas and Denvir, Martin and Dweck, Marc and Flint, Laura and Fyfe, Samantha and Grubb, Neil and Keanie, Collette and Lang, Chris and MacGillivray, Tom and MacLachlan, David and MacLeod, Margaret and Mirsadraee, Saeed and Morrison, Avril and Mills, Nicholas and Northridge, David and Phillips, Alyson and Queripel, Laura and Weir, Nicholas and Jacob, Ashok and Bett, Fiona and Divers, Frances and Fairley, Katie and Keegan, Edith and White, Tricia and Fowler, Julia and Gemmill, John and McGowan, James and Henry, Margo and Francis, Mark and Sandeman, Dennis and Dinnel, Lorraine and Bloomfield, Peter and Denvir, Martin and Henriksen, Peter and MacLeod, Donald and Morrison, Avril and Mordi, Ify and Tzemos, Nikolaos and Connolly, Eugene and Boylan, Heather and Brown, Ammani and Farrell, Lesley and Frood, Alison and Glover, Caroline and Johnstone, Janet and Lanaghan, Kirsten and McGlynn, Deborah and McGregor, Lorraine and McLennan, Evonne and Murdoch, Laura and Paterson, Victoria and Teyhan, Fiona and Teenan, Marion and Woodward, Rosie and Steedman, Tracey}, title = {Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial}, volume = {103}, number = {13}, pages = {995--1001}, year = {2017}, doi = {10.1136/heartjnl-2016-310129}, publisher = {BMJ Publishing Group Ltd}, 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{\textpm}0.4), moderate angina stability (44{\textpm}0.4), modest angina frequency (68{\textpm}0.4), excellent treatment satisfaction (92{\textpm}0.2) and moderate impairment of quality of life (55{\textpm}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.}, issn = {1355-6037}, URL = {https://heart.bmj.com/content/103/13/995}, eprint = {https://heart.bmj.com/content/103/13/995.full.pdf}, journal = {Heart} }