SCOT-HEART 2 Trial: CT Angiography Boosts Lifestyle Changes and Preventive Therapy in Cardiovascular Care

The key findings were as follows:

• 17% of participants who underwent CT angiography adopted healthier lifestyle behaviors, compared to 6% in the risk-scoring group.
• Fewer participants in the CT angiography group were recommended preventive therapies (51%) compared to the risk-scoring group (75%).
• Willingness to follow preventive treatment recommendations was higher in the CT angiography group (77%) than in the risk-scoring group (46%).
• The overall use of lipid-lowering therapies was similar between both groups.
• Antiplatelet therapy use was much higher in the CT angiography group (40%) compared to the risk-scoring group (0.5%).
• Participants in the CT angiography group showed modest improvements in blood pressure, cholesterol levels, and 10-year cardiovascular risk estimates, especially in those with coronary atheroma.

“These findings suggest that seeing clear evidence of coronary atherosclerosis through imaging may motivate patients to take preventive action more seriously,” the authors noted. However, they also emphasized that it remains unclear whether such a strategy ultimately translates to fewer coronary events over the long term.

The authors concluded, "Overall, this substudy emphasizes the potential value of incorporating coronary CT angiography into preventive care strategies, not only to guide therapy but also to foster greater engagement in heart-healthy behaviors. Future research will be needed to confirm whether these improvements in risk factor management can lead to better clinical outcomes."

Reference:

McDermott M, Khaing PH, Meah MN, et al. CT Angiography, Healthy Lifestyle Behaviors, and Preventive Therapy: A Nested Substudy of the SCOT-HEART 2 Randomized Clinical Trial. JAMA Cardiol. Published online June 18, 2025. doi:10.1001/jamacardio.2025.1763