Evidence map›Paper›PMID 39453783›Full record

Trial reportEuropean heart journal2025

Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials.

Laust Dupont Rasmussen, Samuel Emil Schmidt, Juhani Knuuti, Christiaan Vrints, Morten Bøttcher, Borek Foldyna, Michelle C Williams, David E Newby, Pamela S Douglas, Simon Winther

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Review
  3. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Laust Dupont RasmussenDepartment of Cardiology, Gødstrup Hospital, Herning, Denmark.ORCID 0000-0002-2790-2608
Samuel Emil SchmidtDepartment of Health Science and Technology, Aalborg University, Aalborg, Denmark.ORCID 0000-0002-0917-634X
Juhani KnuutiHeart Center, Turku University Hospital, Turku, Finland.
Christiaan VrintsResearch Group Cardiovascular Diseases, Department GENCOR, Faculty of Medicine and Health Sciences, University of Antwerp, Antwerp, Belgium.ORCID 0000-0002-9263-5702
Morten BøttcherDepartment of Cardiology, Gødstrup Hospital, Herning, Denmark.ORCID 0000-0002-2116-2370
Borek FoldynaCardiovascular Imaging Research Center, Department of Radiology, Mass. General Hospital-Harvard Medical School, Boston, MA, USA.ORCID 0000-0002-2466-4827
Michelle C WilliamsBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.
David E NewbyBritish Heart Foundation Centre for Cardiovascular Science, University of Edinburgh, Edinburgh, UK.ORCID 0000-0001-7971-4628
Pamela S DouglasDuke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.ORCID 0000-0001-9876-4049
Simon WintherDepartment of Cardiology, Gødstrup Hospital, Herning, Denmark.ORCID 0000-0001-8872-3681

Funding

Academy of FinlandBritish Heart Foundation CH/09/002British Heart Foundation FS/ICRF/20/26002Danish Cardiovascular Academy PD5Y-2023001-DCADanish Heart FoundationFinnish Foundation of Cardiovascular ResearchNovo Nordisk Foundation NNF20SA0067242Novo Nordisk Foundation Clinical Emerging Investigator grant NNF21OC0066981toTurku University Hospital VTR-
6 · The paper itself

Abstract

BACKGROUND AND

aimsWhether index testing using coronary computed tomography angiography (CTA) improves outcomes in stable chest pain is debated. The risk factor weighted clinical likelihood (RF-CL) model provides likelihood estimation of obstructive coronary artery disease. This study investigated the prognostic effect of coronary CTA vs. usual care by RF-CL estimates.

methodsLarge-scale studies randomized patients (N = 13 748) with stable chest pain to coronary CTA as part of the initial work-up in addition to or instead of usual care including functional testing. Patients were stratified according to RF-CL estimates [RF-CL: very-low (≤5%), low (>5%-15%), and moderate/high (>15%)]. The primary endpoint was myocardial infarction or death at 3 years.

resultsThe primary endpoint occurred in 313 (2.3%) patients. Event rates were similar in patients allocated to coronary CTA vs. usual care [risk difference (RD) 0.3%, hazard ratio (HR) 0.84 (95% CI 0.67-1.05)]. Overall, 33%, 44%, and 23% patients had very-low, low, and moderate/high RF-CL. Risk was similar in patients with very low and moderate/high RF-CL allocated to coronary CTA vs. usual care [very low: RD 0.3%, HR 1.27 (0.74-2.16); moderate/high: RD 0.5%, HR 0.88 (0.63-1.23)]. Conversely, patients with low RF-CL undergoing coronary CTA had lower event rates [RD 0.7%, HR 0.67 (95% CI 0.47-0.97)]. The number needed to test using coronary CTA to prevent one event within 3 years was 143.

conclusionsDespite an overall good prognosis, low RF-CL patients have reduced risk of myocardial infarction or death when allocated to coronary CTA vs. usual care. Risk is similar in patients with very-low and moderate/high likelihood.

Indexed as

Chest PainComputed Tomography AngiographyCoronary Artery DiseaseAgedCoronary AngiographyFemaleHumansMaleMiddle AgedMyocardial InfarctionPrognosisRisk AssessmentRisk FactorsChronic coronary syndromeClinical likelihoodCoronary computed tomography angiographyPre-test probability

Identifiers

PMID39453783
PMCPMC11788567

What Socratic holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.