PRECISE trial at a glance
Precision strategy (n = 1,057) | Usual-testing strategy (n = 1,046) | |
---|---|---|
Intervention | Risk stratification using PROMISE minimal risk score: if score was > 0.46, then further testing was deferred unless patients had known vascular calcifications or atherosclerosis Cardiac testing with CT angiography: if 30% to 90% stenosis was present, then CT fractional flow reserve was added | Physician-guided decision-making: options included deferred testing, stress testing, or cardiac catheterization |
Patients who had cardiac testing, n (%) | 883 (83.5)a | 978 (93.5)a |
Initial cardiac testing, % | ||
CT angiography | 48 | < 1 |
CT angiography + CT fractional flow reserve | 31 | < 1 |
Cardiac catheterization | < 1 | 10 |
Single-photon emission computed tomography-positron emission tomography | 2 | 32 |
Stress echocardiography | 2 | 30 |
Treadmill electrocardiography | 1 | 11 |
Stress cardiac magnetic resonance imaging | < 1 | 10 |
No test | 16 | 7 |
Patients who had cardiac catheterization, n (%) | 135 (12.8)a | 177 (16.9)a |
Patients with primary composite endpoint (death, nonfatal myocardial infarction, or cardiac catheterization without obstructive coronary artery disease), n (%) | 44 (4.2)a | 118 (11.3)a |
Death or nonfatal myocardial infarction | 18 (1.7) | 12 (1.1) |
Cardiac catheterization without obstructive coronary artery disease | 27 (2.6)a | 107 (10.2)a |
Patients who had revascularization, n (%) | 97 (9.2)a | 54 (5.2)a |
↵a Statistically significant difference.
CT = computed tomography; PRECISE = Prospective Randomized Trial of the Optimal Evaluation of Cardiac Symptoms and Revascularization; PROMISE = Prospective Multicenter Imaging Study for Evaluation of Chest Pain
Based on information from reference 7.