|Trial Name (Ref. #)||Randomization||N, Total and by Arm||Intervention Details||Duration of Follow-Up, yrs∗||Major Endpoint†||HR (95% CI)|
|CECaT (20)||Invasive angiography vs. stress echocardiography, SPECT, or CMR||1:1 randomization (N = 898)|
Angiography n = 222 vs. echocardiography n = 226,
SPECT n = 224, or CMR n = 226
|Invasive angiography was the comparator vs. SPECT, echocardiography, and CMR||2.0||All-cause mortality||p = 0.054|
|CRESCENT (36)||Coronary CTA vs. exercise ECG||2:1 randomization (N = 350)|
Coronary CTA = 242 vs. exercise ECG = 108
|Coronary CTA arm included index CAC evaluation with Coronary CTA limited to CAC >0||1.0||All-cause mortality, MI, major stroke, unstable angina, unplanned CAD evaluation, or late revascularization||0.32 (0.13–0.81)|
p = 0.011
|PROMISE (18)||Anatomic (Coronary CTA) vs. functional test strategy||1:1 randomization (N = 10,003)|
Coronary CTA n = 4,996 vs. stress test n = 5,007
67% nuclear, 23% echocardiography, 10% ECG
|2.1||Death, MI, unstable angina hospitalization, or major complications||1.04 (0.83–1.29)|
p = 0.75
|SCOT-HEART (19)||SC + Coronary CTA vs. SC||1:1 randomization (N = 4,146)|
SC + Coronary CTA = 2,073 vs. SC = 2,073
|Index evaluation often included exercise ECG (85%)||1.7||Primary: certainty of angina diagnosis caused by CAD|
Secondary: coronary heart disease death or MI
p = 0.053
|WOMEN (33)||Exercise SPECT vs. exercise ECG||1:1 randomization (N = 824)|
SPECT n = 412 vs. ECG n = 412
|Inclusion of women with DASI estimate ≥5 METs||2.0||CAD death, MI, or hospitalization for acute coronary syndrome or heart failure||1.3 (0.5–3.5)|
p = 0.59
CAC = coronary artery calcium; CAD = coronary artery disease; CECaT = Cost-Effectiveness of noninvasive Cardiac Testing; CI = confidence interval; CMR = cardiac magnetic resonance; CRESCENT = Computed Tomography vs. Exercise Testing in Suspected Coronary Artery Disease; CTA = computed tomographic angiography; DASI = Duke Activity Status Index; ECG = electrocardiogram; HR = hazard ratio; MET = metabolic equivalents; MI = myocardial infarction; PROMISE = Prospective Multicenter Imaging Study for Evaluation of Chest Pain; SC = standard care; SCOT-HEART = Scottish Computed Tomography of the HEART; SPECT = single-photon emission computed tomography; WOMEN = What is the Optimal Method of Ischemia Elucidation in Women?
↵∗ Duration of follow-up is reported as median values for PROMISE and SCOT-HEART.
↵† Primary endpoint is reported for all but SCOT-HEART and CECaT trials where outcomes are a secondary endpoint.
↵‡ No HR was reported from the CECaT trial. However, the HR for angiography vs. stress CMR was elevated 2.6-fold (95% CI: 1.1 to 6.2) but not significant for angiography vs. stress echocardiography or SPECT.