Enhanced Preventative Therapy With Coronary Computed Tomographic Angiography Added Value Beyond Simple Risk Calculators?

We read with interest the most recent publication from the SCOT-HEART (Scottish COmputed Tomography of the HEART) investigators that raised the prospect of using coronary computed tomographic angiography (CCTA) results to guide medical therapy (1). Even though it is difficult to make definitive conclusions from a post hoc analysis of a secondary endpoint, especially with so few events, testing this hypothesis seems most reasonable in patients who are already on optimal medical therapy based upon their clinical risk. Specifically, can CCTA results, when obtained in symptomatic patients, facilitate enhanced medical therapy?

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