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Background: In a prospective, multicenter, randomized controlled trial, 4,146 patients were randomized to receive standard care or standard care plus coronary computed tomography angiography (CCTA). Objectives: The purpose of this study was to explore the consequences of CCTA-assisted diagnosis on invasive coronary angiography, preventive treatments, and clinical outcomes. Methods: In post hoc analyses, we assessed changes in invasive coronary angiography, preventive treatments, and clinical outcomes using national electronic health records. Results: Despite similar overall rates (409 vs. 401; p= 0.451), invasive angiography was less likely to demonstrate normal coronary arteries (20 vs. 56; hazard ratios HRs: 0.39 95% confidence interval (CI): 0.23 to 0.68; p< 0.001) but more likely to show obstructive coronary artery disease (283 vs. 230; HR: 1.29 95% CI: 1.08 to 1.55; p= 0.005) in those allocated to …