PT  - JOURNAL ARTICLE
AU  - Khaled Alfakih
AU  - Jonathan Byrne
AU  - Mark Monaghan
TI  - CT coronary angiography: a paradigm shift for functional imaging tests
AID  - 10.1136/openhrt-2017-000754
DP  - 2018 Mar 01
TA  - Open Heart
PG  - e000754
VI  - 5
IP  - 1
4099  - http://openheart.bmj.com/content/5/1/e000754.short
4100  - http://openheart.bmj.com/content/5/1/e000754.full
SO  - Open Heart2018 Mar 01; 5
AB  - 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.