TARGET-CTCA

The main aim of the study is to find out if a heart scan (called a computed tomography coronary angiogram) will benefit patients who have come to hospital with chest pain but haven’t had a heart attack. 

This study has now published the results of the main trial. Please scroll down to read more.

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Chief Investigator: Professor Nick Mills

Number and location of participating sites / geographical scope (by region/country): 

• NHS Lothian 
• NHS Greater Glasgow & Clyde 
• Lewisham & Greenwich NHS Trust 
• Plymouth NHS Trust 
• Torbay & South Devon NHS Foundation Trust 
• Royal Berkshire NHS Trust 
• Milton Keynes NHS Trust 
• University Hospital Southampton NHS Trust 
• North Tees and Hartlepool NHS Foundation Trust 

Funder: British Heart Foundation

Start and End date

Of grant award  May 2019 - 28 February 2026

Of recruitment  Sep 2019 - 11 May 2023

Current Status: In August 2026 the results of the main trial were published. We are now in follow up phase.

UK GDPR privacy statement: Available on https://edin.ac/target-ctca-trial

Trial website : https://edin.ac/target-ctca-trial

Sponsor: ACCORD  http://accord.scot/

Chief Investigator Professor Nicholas Mills, Room SU225, Chancellor's Building, University of Edinburgh, Royal Infirmary, Little France, Edinburgh, EH16 4SB, UK

Trial Manager: Edinburgh Clinical Trials Unit, Usher Building, The University of Edinburgh, 5‒7 Little France Road, Edinburgh BioQuarter ‒ Gate 3 EDINBURGH EH16 4UX  Email: Target.CTCA@ed.ac.uk

ECTU Involvement Trial Management / Statistics /  Database

(UKCRC)

TARGET-CTCA study Results

What did we find?

The results for the TARGET CTCA clinical trial were published on the 29^th August 2026 in the New England Journal of Medicine. 

The study included 3,170 people who went to their Emergency Department (ED) with chest pain, and the trial ran across 14 UK hospitals. Everyone who took part had troponin blood test results showing that they had not had a heart attack when they went to their ED, but their results suggested they might have a higher risk of future heart problems. Participants were randomly assigned to either have a CT scan of their heart arteries or receive the usual care.

In simple terms, the objective of the trial was:

“If we use a CT scan (a type of x-ray) to look more closely at the heart arteries after someone has been told they haven't had a heart attack, can that extra information help guide treatment that prevents heart attacks and saves lives in the future?”

The findings from TARGET-CTCA show there was no clear reduction in heart attack or heart-related death.

What have we learned?

The CT scans gave doctors more information about the heart arteries. Among those who had a scan, about one in three had normal arteries, while around two in three had some coronary artery disease. The scan also meant that more people were prescribed treatments such as statins and antiplatelet medicines to help prevent heart problems in the future.

However, after an average of three years of follow-up, having the CT scan did not reduce the chance of having a heart attack or dying from a heart-related cause compared with usual care. In general, about 7 in every 100 people in each group experienced one of these outcomes. Specifically, there were 1,587 participants assigned to have a CT scan and, of these, 112 (7.1%) had a heart attack or a heart-related death. Additionally, there were 1,583 participants assigned to receive their usual care and 116 (7.3%) of these had a heart attack or a heart-related death. 

The results suggest that routinely giving people in this situation a CT scan of their heart arteries to guide treatment does not, by itself, reduce their risk of future heart attack or heart-related death. This is valuable knowledge because it will help avoid unnecessary tests and simplify care after a heart attack is ruled out. 

Thank you! 

We would like to extend our heartfelt thanks to everyone who took part in the TARGET-CTCA study. We are extremely grateful for the time you gave us and for your willingness to take part in the research. Your contribution has been invaluable in helping us answer an important question about how best to care for people who attend hospital with chest pain.

We would also like to thank the research teams across the UK who made the study possible. This includes the doctors, nurses and research staff at hospitals across Glasgow and Edinburgh, as well as University Hospital Southampton, University Hospital Lewisham & Greenwich, Torbay Hospital, University Hospital of North Tees & Hartlepool, Milton Keynes University Hospital, Royal Berkshire Hospital, Victoria Hospital in Fife and Derriford Hospital in Plymouth. We are very grateful for their dedication and hard work throughout the study.

Our thanks also go to our Patient and Public Involvement (PPIE) advisors as well as ACCORD, our study sponsor, and to the statisticians, data managers and trial managers at the Edinburgh Clinical Trials Unit, whose expertise and commitment helped us conduct the study to the highest standards of clinical research.

Finally, we gratefully acknowledge the British Heart Foundation, whose generous support made this research possible.

Link to a summary of the scientific article in the NEJM: Click here

Alternatively you can scan here: 

Link to the Chief Investigator (Prof. Nick Mills) providing a scientific summary at a conference on the 29^th August 2026: Click here

Link to the lay summary on the BHF website: Click here