PT - JOURNAL ARTICLE AU - Michelle C Williams AU - Amanda Hunter AU - Anoop Shah AU - Valentina Assi AU - Stephanie Lewis AU - Kenneth Mangion AU - Colin Berry AU - Nicholas A Boon AU - Elizabeth Clark AU - Marcus Flather AU - John Forbes AU - Scott McLean AU - Giles Roditi AU - Edwin JR van Beek AU - Adam D Timmis AU - David E Newby TI - Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial AID - 10.1136/heartjnl-2016-310129 DP - 2017 Jul 01 TA - Heart PG - 995--1001 VI - 103 IP - 13 4099 - http://heart.bmj.com/content/103/13/995.short 4100 - http://heart.bmj.com/content/103/13/995.full SO - Heart2017 Jul 01; 103 AB - 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.