The prospective randomized trial of the optimal evaluation of cardiac symptoms and revascularization: Rationale and design of the PRECISE trial

Autor: Michael G. Nanna, Sreekanth Vemulapalli, Christopher B. Fordyce, Daniel B. Mark, Manesh R. Patel, Hussein R. Al-Khalidi, Michelle Kelsey, Beth Martinez, Eric Yow, Sarah Mullen, Gregg W. Stone, Ori Ben-Yehuda, James E. Udelson, Campbell Rogers, Pamela S. Douglas
Rok vydání: 2021
Předmět:
Zdroj: Am Heart J
ISSN: 1097-6744
Popis: BACKGROUND: Clinicians vary widely in their preferred diagnostic approach to patients with non-acute chest pain. Such variation exposes patients to potentially avoidable risks, as well as inefficient care with increased costs and unresolved patient concerns. OBJECTIVES: The Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization (PRECISE) trial (NCT03702244) compares an investigational “precision” diagnostic strategy to a usual care diagnostic strategy in participants with stable chest pain and suspected coronary artery disease (CAD). STUDY DESIGN: PRECISE randomized 2103 participants with stable chest pain and a clinical recommendation for testing for suspected CAD at 68 outpatient international sites. The investigational precision evaluation strategy started with a pre-test risk assessment using the PROMISE Minimal Risk Tool. Those at lowest risk were assigned to deferred testing (no immediate testing), and the remainder received coronary computed tomographic angiography (cCTA) with selective fractional flow reserve (FFR(CT)) for any stenosis meeting a threshold of ≥30% and
Databáze: OpenAIRE