TY - JOUR T1 - CT coronary angiography: a paradigm shift for functional imaging tests JF - Open Heart JO - Open Heart DO - 10.1136/openhrt-2017-000754 VL - 5 IS - 1 SP - e000754 AU - Khaled Alfakih AU - Jonathan Byrne AU - Mark Monaghan Y1 - 2018/03/01 UR - http://openheart.bmj.com/content/5/1/e000754.abstract N2 - The UK National Institute for Health and Care Excellence (NICE) have just updated their guideline on new-onset stable chest pain, recommending that all patients should be investigated with a CT coronary angiography (CTCA). In a separate guideline, NICE recommended CT fractional flow reserve (CT-FFR), to assess coronary stenoses, found on CTCA, stating that this would reduce the need for invasive coronary angiography and hence reduce cost. We discuss the evidence base for CT-FFR and emphasise that we already have established functional imaging tests, with extensive evidence base for efficacy and prognosis and that CT-FFR should be compared with this standard of care and not with the much more expensive and invasive fractional flow reserve undertaken during invasive coronary angiography. ER -