PRECISE Trial
Rewrites the
Patient Pathway

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

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The PRECISE Trial

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).


65
Global Sites
2,103
Patients
Adjudicated
Core Lab, CEC1
Precision Pathway
Risk scoring to defer testing for low-risk patients.2
CCTA with selective FFRCT3 for elevated risk patients.
Traditional Testing
Functional testing (stress nuclear and stress echo) and Invasive Coronary Angiography (ICA).

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:



More accurate non-invasive diagnosis




Fewer unnecessary tests



Reduced long-term risk by increasing preventive therapies5


Download the Data Sheet

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


Download the Data Sheet

REFERENCES

  1. Clinical Events Committee (CEC)
  2. 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.
  3. For stenoses 30-90%
  4. Deaths include one participant with a fatal MI. One MI on the day of randomization was determined by CEC to have preceded study entry and was excluded.
  5. Joshi, et al. JAMA 2021.

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