RT Journal Article SR Electronic T1 CT coronary angiography: a paradigm shift for functional imaging tests JF Open Heart JO Open Heart FD British Cardiovascular Society SP e000754 DO 10.1136/openhrt-2017-000754 VO 5 IS 1 A1 Khaled Alfakih A1 Jonathan Byrne A1 Mark Monaghan YR 2018 UL http://openheart.bmj.com/content/5/1/e000754.abstract 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.