Lowenstern A, Alexander KP, Hill CL, et al. - Given a rise in cardiovascular (CV) disease with age but lack of the best noninvasive test to recognize older patients who carry the risk for CV events, researchers undertook this prespecified analysis of the PROMISE study, which employed a pragmatic comparative effectiveness design, to investigate if the prognostic efficacy of anatomic vs functional testing differs depending on patient age. The participants were recruited from 193 sites across North America. Outpatients free of known coronary artery disease (CAD) but having symptoms indicative of CAD were included. The participants were randomized to noninvasive testing with coronary computed tomographic angiography or functional testing. A median follow-up of 25 months was performed, during which, the composite of CV death/myocardial infarction (MI) was assessed. A positive noninvasive test result and more coronary artery calcium were more likely to be seen among older patients with stable symptoms suggestive of CAD. However, only a positive functional test outcome was found to be related to the risk of CV death/MI. Further assessment of age-specific strategies to noninvasive evaluation of CAD was advised.