title: Symptoms and quality of life in patients with suspected angina undergoing CT coronary angiography: a randomised controlled trial.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  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.
  
  
  
  NCT01149590.
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Michelle C
authors.identifier: 0000-0003-3556-2428
authors.initials: MC
authors.lastname: Williams
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Amanda
authors.initials: A
authors.lastname: Hunter
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Anoop
authors.initials: A
authors.lastname: Shah
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Valentina
authors.initials: V
authors.lastname: Assi
authors.affiliation: Centre for Population Health Sciences, University of Edinburgh, Edinburgh, UK.
authors.forename: Stephanie
authors.initials: S
authors.lastname: Lewis
authors.affiliation: Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Kenneth
authors.initials: K
authors.lastname: Mangion
authors.affiliation: Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Colin
authors.initials: C
authors.lastname: Berry
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Nicholas A
authors.initials: NA
authors.lastname: Boon
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Clark
authors.affiliation: Norwich Medical School, University of East Anglia, UK.
authors.forename: Marcus
authors.initials: M
authors.lastname: Flather
authors.affiliation: University of Limerick, Limerick, Ireland.
authors.forename: John
authors.initials: J
authors.lastname: Forbes
authors.affiliation: National Health Service, Fife, UK.
authors.forename: Scott
authors.initials: S
authors.lastname: McLean
authors.affiliation: Institute for Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK.
authors.forename: Giles
authors.initials: G
authors.lastname: Roditi
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: Edwin Jr
authors.initials: EJ
authors.lastname: van Beek
authors.affiliation: William Harvey Research Institute, Queen Mary University of London, London, UK.
authors.forename: Adam D
authors.initials: AD
authors.lastname: Timmis
authors.affiliation: British Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
authors.forename: David E
authors.initials: DE
authors.lastname: Newby
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000175:diagnosis* / Q000209:etiology / Q000523:psychology; D000072226:Computed Tomography Angiography / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003327:Coronary Disease / Q000150:complications* / Q000175:diagnosis; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011788:Quality of Life; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D055815:Young Adult