Key result
The TARGET trial is a study protocol designed to evaluate whether a CCTA/CT-FFR strategy reduces the rate of planned invasive coronary angiography without significant obstructive CAD compared to usual care.
Why the study?
The diagnostic accuracy of CT-FFR has been validated, but its effect on management decision-making has not been fully evaluated in a randomized controlled design.
Does a CCTA/CT-FFR strategy reduce planned invasive coronary angiography without significant obstructive CAD in intermediate-to-high risk patients with suspected CAD compared to usual care?
RCT (n=1,216)
Open-label
1:1 computer-generated random numbers
Yes
Does a CCTA/CT-FFR strategy reduce planned invasive coronary angiography without significant obstructive CAD in intermediate-to-high risk patients with suspected CAD compared to usual care?
The TARGET trial protocol outlines a randomized study to determine if a CT-FFR-guided strategy reduces unnecessary invasive coronary angiography compared to usual care in patients with suspected CAD.
TARGET protocol tests CCTA/CT-FFR for ICA triage; leaves open whether this reduces unnecessary procedures or improves outcomes.
BACKGROUND: The diagnostic accuracy of CT-derived fractional flow reserve (CT-FFR) in clinical application has been well validated. This advanced technology focus on evaluating anatomical stenosis and functional ischemia simultaneously. However, the effect of CT-FFR on the management of decision making has not been fully evaluated in randomized controlled design. METHOD/DESIGN: TARGET study is a pragmatic, multicenter, prospective, open-label, and randomized controlled trial evaluating the effect of a CCTA/CT-FFR strategy (group A) versus usual care (group B) on intermediate-to-high risk patients with suspected CAD who undergo clinically indicated diagnostic evaluation. A total sample size of 1216 subjects will be enrolled and followed up for 12 months. This study will be performed in 6 Chinese hospitals, and the primary endpoint is the planned ICA without significant obstructive CAD within 90 days. The secondary endpoints include MACE, quality of life, medical expenditure, and cumulative radiation exposure during 1-year follow-up. DISCUSSION: The study will provide information to patients, health care providers, and other stakeholders in China about which strategy could be more effective in the management of intermediate-to-high risk patients with suspect CAD. TRIAL REGISTRATION: ClinicalTrials.gov NCT03901326 . Registered on 3 April 2019.
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Yang et al. (2020) conducted an RCT in Stable chest pain with suspected coronary artery disease (n=1,216). CCTA/CT-FFR strategy vs. Usual care was evaluated on Planned invasive coronary angiography (ICA) without significant obstructive CAD within 90 days. The TARGET trial is a study protocol designed to evaluate whether a CCTA/CT-FFR strategy reduces the rate of planned invasive coronary angiography without significant obstructive CAD compared to usual care.
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