PRECISE Trial Rewrites the Patient Pathway

Helping physicians get the right patient, the right care at the right time.

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It’s confirmed. The Precision Pathway recognized in the AHA/ACC guidelines — centered around Coronary CTA+FFRCT — is superior to Traditional Testing, which prioritizes functional (stress) testing and Invasive Coronary Angiography (ICA).1

Physician Perspectives on the PRECISE Trial

The PRECISE Trial – A conversation with Dr. James Udelson, Tufts Medical Center

KOLs Agree! PRECISE supports Chest Pain Guidelines, CCTA+FFRCT Pathway good for patient care, cath lab efficiency

PRECISE 1 Year Results Quick Summary with Pam Douglas

A closer look at the PRECISE Trial

Webinar: This panel of leading experts discusses insights from the PRECISE Trial 1-Year data, how the findings relate to the 2021 AHA/ACC Chest Pain Guidelines, and what the data tell us about different strategies for the evaluation and diagnosis of coronary artery disease. Featuring Dr. Pamela S. DouglasDr. Maros Ferencik, and Dr. Gregg W. Stone

1-Year Primary Endpoint Results

The Precision Pathway, centered around CCTA+FFRCT, achieved its primary endpoint by significantly reducing the composite of all-cause death, nonfatal MI, or catheterization without obstructive disease relative to Traditional Testing at 1 year.

Key Findings

Precision Pathway compared to Traditional Testing:


Global Sites




Core Lab, CEC2

Precision Pathway

Risk scoring to defer testing for low-risk patients.3

CCTA with selective FFRCT4 for elevated risk patients.

Traditional Testing

Functional testing (stress nuclear and stress echo) and Invasive Coronary Angiography (ICA).

More accurate non-invasive diagnosis

Fewer unnecessary tests

Reduced long-term risk by increasing preventive therapies5


The PRECISE Trial Design

Patients with non-acute chest pain or the equivalent requiring testing for suspected CAD.

No history of Obstructive CAD or CAD testing < 1 year: N=2103

Randomized into one of two pathways.
Randomization stratified by site, PROMISE Minimal Risk Score (Low Risk vs. Elevated Risk), and intended first test (if randomized to Traditional Testing).

All subsequent care and testing decisions made by site clinician.
Guideline-directed medical management recommended for all.

Primary Endpoint (1 year)
Death, Nonfatal MI, Cath without obstructive CAD

Secondary Endpoints
Death, Nonfatal MI, Unplanned CV Hospitalizations, Radiation, Preventive Medication Use, Cath Yield, Resource Use, Quality of Life


  1. Douglas, et al. Comparison of an Initial Risk-Based Testing Strategy vs Usual Testing in Stable Symptomatic Patients With Suspected Coronary Artery Disease. JAMA Cardiol. 2023. 
  2. Clinical Events Committee (CEC)
  3. Patient risk was determined using the PROMISE Minimal Risk Score. PROMISE variables include: age, sex, ethnicity, smoking history, diabetes mellitus, dyslipidemia, family history of premature coronary artery disease, hypertension, symptoms related to stress and high-density lipoprotein (HDL) concentration.
  4. For stenoses 30-90%
  5. Joshi, et al. JAMA 2021.

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Campbell Rogers, M.D., F.A.C.C.

Executive Vice President and Chief Medical Officer

Campbell brings a wealth of experience to HeartFlow, where he serves as the Chief Medical Officer. Prior to joining HeartFlow, he was the Chief Scientific Officer and Global Head of Research and Development at Cordis Corporation, Johnson & Johnson, where he was responsible for leading investments and research in cardiovascular devices. Prior to Cordis, he was Associate Professor of Medicine at Harvard Medical School and the Harvard-M.I.T. Division of Health Sciences and Technology, and Director of the Cardiac Catheterization and Experimental Cardiovascular Interventional Laboratories at Brigham and Women’s Hospital. He served as Principal Investigator for numerous interventional cardiology device, diagnostic, and pharmacology trials, is the author of numerous journal articles, chapters, and books in the area of coronary artery and other cardiovascular diseases, and was the recipient of research grant awards from the NIH and AHA.

He received his A.B. from Harvard College and his M.D. from Harvard Medical School.