Trial reportEuropean heart journal2021
Fractional flow reserve derived from computed tomography coronary angiography in the assessment and management of stable chest pain: the FORECAST randomized trial.
Trial report in European heart journal, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 76 papers, 2 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
76 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- Pooled it
- Representation of Older Adults and Women in Randomized Trials of Noninvasive Imaging for Chest Pain.Circulation. Cardiovascular imaging · 2025Pooled it
- Sex Differences in Computed Tomography Coronary Stenosis Severity Versus Flow Impairment and Impact on Revascularization, Clinical Events and Health Care Costs: A FORECAST Substudy.Journal of the American Heart Association · 2025Trial
- Economic Outcomes With Precision Diagnostic Testing Versus Usual Testing in Stable Chest Pain: Results From the PRECISE Randomized Trial.Circulation. Cardiovascular quality and outcomes · 2025Trial
- Acoustic-based rule-out of stable coronary artery disease: the FILTER-SCAD trial.European heart journal · 2025Trial
- Left main coronary artery stenosis assessment on coronary CT angiography.European journal of radiology open · 2026Article
- Advanced quantitative CT for coronary artery disease: integrating stenosis quantification, plaque quantification, and fractional flow reserve-CT.The British journal of radiology · 2026Review
- The Shifting Boundary Between Invasive and Non-Invasive Angiographic Investigation in Contemporary Cardiology and Cardiac Surgery: An Up-to-Date Narrative Review.Journal of clinical medicine · 2026Review
- Korean Society of Interventional Cardiology Expert Consensus for the Management of Chronic Coronary Syndrome: Part 1.Korean circulation journal · 2026Review
- Clinical use of coronary computed tomography angiography-derived fractional flow reserve: expert consensus by an International Working Group.European radiology · 2026Article
- Great debate: the new risk factor-weighted clinical likelihood model is useful to estimate the initial pre-test probability of obstructive coronary artery disease in individuals with suspected chronic coronary syndromes.European heart journal · 2026Article
- FFR-CT: Technical Advances and Implementation in Clinical Practice.Journal of imaging · 2026Review
- From Plaque to Perfusion: A Narrative Review of Multimodality Imaging in Acute Coronary Syndromes.Journal of clinical medicine · 2026Article
- Digital twins and simulations in transcatheter coronary and structural heart interventions.European heart journal. Digital health · 2026Review
- Myocardial infarction, stroke and arterial stenosis: time to reassess a major misunderstanding.Nature reviews. Cardiology · 2026Review
- CCTA-derived plaque component-inflammation load is associated with concurrent CT-FFR-defined functional limitation: a retrospective cross-sectional imaging study.Frontiers in cardiovascular medicine · 2026Article
- Complete Revascularisation in ST-elevation MI: Do We Really Buy It? Challenging the Current Approach to Bystander Percutaneous Coronary Intervention.Interventional cardiology (London, England) · 2026Review
- Cardiac CT for personalized phenotyping in stable coronary artery disease: toward precision medicine.BJR open · 2026Review
- Comparison of computed tomography coronary angiography (CTCA) alone vs. CTCA with selective FFREuropean heart journal. Imaging methods and practice · 2025Article
- Coronary Computed Tomography Angiography-Derived Fractional Flow Reserve: A Comprehensive Review.Reviews in cardiovascular medicine · 2025Review
16 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
26 authors.
Funding
Abstract
aimsFractional flow reserve (FFRCT) using computed tomography coronary angiography (CTCA) determines both the presence of coronary artery disease and vessel-specific ischaemia. We tested whether an evaluation strategy based on FFRCT would improve economic and clinical outcomes compared with standard care. METHODS AND
resultsOverall, 1400 patients with stable chest pain in 11 centres were randomized to initial testing with CTCA with selective FFRCT (experimental group) or standard clinical care pathways (standard group). The primary endpoint was total cardiac costs at 9 months. Secondary endpoints were angina status, quality of life, major adverse cardiac and cerebrovascular events, and use of invasive coronary angiography. Randomized groups were similar at baseline. Most patients had an initial CTCA: 439 (63%) in the standard group vs. 674 (96%) in the experimental group, 254 of whom (38%) underwent FFRCT. Mean total cardiac costs were higher by £114 (+8%) in the experimental group, with a 95% confidence interval from -£112 (-8%) to +£337 (+23%), though the difference was not significant (P = 0.10). Major adverse cardiac and cerebrovascular events did not differ significantly (10.2% in the experimental group vs. 10.6% in the standard group) and angina and quality of life improved to a similar degree over follow-up in both randomized groups. Invasive angiography was reduced significantly in the experimental group (19% vs. 25%, P = 0.01).
conclusionA strategy of CTCA with selective FFRCT in patients with stable angina did not differ significantly from standard clinical care pathways in cost or clinical outcomes, but did reduce the use of invasive coronary angiography.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.