PMID- 31932171
OWN - NLM
STAT- MEDLINE
DCOM- 20210125
LR  - 20210125
IS  - 1878-0938 (Electronic)
IS  - 1878-0938 (Linking)
VI  - 21
IP  - 7
DP  - 2020 Jul
TI  - Fractional Flow Reserve Derived from Computed Tomography Coronary Angiography in 
      the Assessment and Management of Stable Chest Pain: Rationale and Design of the 
      FORECAST Trial.
PG  - 890-896
LID - S1553-8389(19)30805-X [pii]
LID - 10.1016/j.carrev.2019.12.009 [doi]
AB  - BACKGROUND: Fractional flow reserve measurement based on computed tomography 
      (FFR(CT)) is a novel, well validated, non-invasive method for determining the 
      presence and extent of coronary artery disease (CAD) combined with a 
      physiological assessment of vessel-specific ischemia in patients with chest pain. 
      Previous studies indicate that FFR(CT) reduces the uptake of invasive angiography 
      that shows no significant CAD, without compromising patient safety. The clinical 
      effectiveness and economic impact of using FFR(CT) instead of other tests in the 
      initial evaluation of patients with stable chest pain has not been tested in a 
      randomized trial. METHODS: The FORECAST trial will randomise 1400 patients with 
      stable chest pain to receive either FFR(CT) or routine clinical assessment as 
      directed by the National Institute for Health and Care Excellence (NICE) CG95 
      guideline for Chest Pain of Recent Onset. The primary endpoint will be resource 
      utilisation over the subsequent nine months, including non-invasive cardiac 
      investigations, invasive coronary angiography, coronary revascularization, 
      hospitalization for cardiac events, and the use of cardiac medications. Key 
      pre-specified secondary endpoints will be major adverse cardiac events, angina 
      severity, quality of life, patient satisfaction, time to definitive management 
      plan, time to completion of initial evaluation, number of hospital attendances, 
      and working days lost in patients who are in employment. CONCLUSION: The FORECAST 
      randomized trial will assess the clinical and economic outcomes of using FFR(CT) 
      as the primary test to evaluate patients presenting with stable chest pain.
CI  - Copyright (c) 2019 Elsevier Inc. All rights reserved.
FAU - Mahmoudi, Michael
AU  - Mahmoudi M
AD  - Faculty of Medicine, University of Southampton, UK.
FAU - Nicholas, Zoe
AU  - Nicholas Z
AD  - Coronary Research Group, University Hospital Southampton, Southampton, UK.
FAU - Nuttall, Jacqui
AU  - Nuttall J
AD  - Clinical Trials Unit, University of Southampton, Southampton, UK.
FAU - Bresser, Moniek
AU  - Bresser M
AD  - Clinical Trials Unit, University of Southampton, Southampton, UK.
FAU - Maishman, Tom
AU  - Maishman T
AD  - Clinical Trials Unit, University of Southampton, Southampton, UK.
FAU - Berry, Colin
AU  - Berry C
AD  - British Heart Foundation Glasgow Cardiovascular Research Centre, University of 
      Glasgow, UK.
FAU - Hlatky, Mark A
AU  - Hlatky MA
AD  - Stanford University School of Medicine, Stanford, CA, USA.
FAU - Douglas, Pamela
AU  - Douglas P
AD  - Duke University School of Medicine, Durham, NC, USA.
FAU - Rajani, Ronak
AU  - Rajani R
AD  - Guy's & St Thomas' NHS Trust, London, UK.
FAU - Fox, Kim
AU  - Fox K
AD  - Imperial College, London, UK.
FAU - Curzen, Nick
AU  - Curzen N
AD  - Faculty of Medicine, University of Southampton, UK; Coronary Research Group, 
      University Hospital Southampton, Southampton, UK. Electronic address: 
      Nick.curzen@uhs.nhs.uk.
LA  - eng
PT  - Clinical Trial Protocol
PT  - Journal Article
DEP - 20191209
PL  - United States
TA  - Cardiovasc Revasc Med
JT  - Cardiovascular revascularization medicine : including molecular interventions
JID - 101238551
SB  - IM
MH  - Angina, Stable/*diagnostic imaging/physiopathology/therapy
MH  - *Computed Tomography Angiography
MH  - *Coronary Angiography
MH  - Coronary Artery Disease/*diagnostic imaging/physiopathology/therapy
MH  - *Fractional Flow Reserve, Myocardial
MH  - Humans
MH  - Multicenter Studies as Topic
MH  - Predictive Value of Tests
MH  - Prognosis
MH  - Prospective Studies
MH  - Randomized Controlled Trials as Topic
MH  - Time Factors
MH  - United Kingdom
COIS- Declaration of competing interest Michael Mahmoudi & Zoe Nicholas have no 
      conflicts of interests. Nick Curzen has received unrestricted research grants 
      from HeartFlow, Haemonetics and Boston Scientific; speaker fees/honoraria from 
      Abbott Vascular, HeartFlow, Haemonetics and Boston Scientific; travel sponsorship 
      from HeartFlow, Haemonetics; Biosensors; Abbott Vascular, Medtronic & Boston 
      Scientific. Mark Hlatky has received research grants from HeartFlow. Colin Berry 
      is employed by the University of Glasgow, which holds consultancy and research 
      agreements with Abbott Vascular, AstraZeneca, Boehringer Ingelheim, Menarini 
      Pharmaceuticals, Philips and Siemens Healthcare. These companies had no 
      involvement in the current research or the manuscript.
EDAT- 2020/01/15 06:00
MHDA- 2021/01/26 06:00
CRDT- 2020/01/15 06:00
PHST- 2019/08/07 00:00 [received]
PHST- 2019/10/23 00:00 [revised]
PHST- 2019/12/03 00:00 [accepted]
PHST- 2020/01/15 06:00 [pubmed]
PHST- 2021/01/26 06:00 [medline]
PHST- 2020/01/15 06:00 [entrez]
AID - S1553-8389(19)30805-X [pii]
AID - 10.1016/j.carrev.2019.12.009 [doi]
PST - ppublish
SO  - Cardiovasc Revasc Med. 2020 Jul;21(7):890-896. doi: 10.1016/j.carrev.2019.12.009. 
      Epub 2019 Dec 9.