Care strategy for patients suspected of having coronary artery disease


Prospective randomized trial of the optimal evaluation of cardiac symptoms and revascularization

This observational randomized clinical trial is comparing the effectiveness of two types of care for patients who have chest pain but are stable and may have heart disease but have not been diagnosed.

Patients are randomized to two groups. One group receives “precision care,” which incorporates a risk-based assignment into either guideline-recommended clinical management or cardiac imaging. The other group receives the current standard of care as directed by their cardiologist.

The precise trial seeks to assess clinical outcomes, decision making regarding noninvasive testing and invasive angiography, as well as costs of using a precision-evaluation strategy vs. a usual-care strategy in patients with stable symptoms of coronary artery disease.

Participants are assigned to either guideline-recommended care without immediately planned testing (low risk) or cCTA with selective FFRct (elevated risk) using a risk tool based on pretest clinical characteristics. Participants assigned to guideline-recommended care without planned testing are treated with preventive and antianginal medical treatment per guideline recommendations and clinical judgment, and followed without testing.

For patients randomized to the usual-care study arm, the participant’s care team will select the specific test.

Inclusion Snapshot

  • Eligible patients must have symptoms of coronary artery disease but have not been diagnosed with such
  • Must not have received any cardiovascular testing within the past 12 months

Contact Information

Lankenau Institute for Medical Research trial

Physician Investigator(s)

Study Locations