Coronary CT Angiography as a Guide to Timing of Invasive Treatment in Patients With NSTEACS

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For patients presenting with non–ST-segment elevation acute coronary syndrome (NSTEACS), large-scale studies have been unable to show effect of an early invasive strategy in an all-comers populations, and the search for subgroups in whom an early invasive strategy could be advantageous remains an important challenge.1,2 Previous studies have shown benefit of an early invasive strategy in patients at high risk according to the GRACE (Global Registry of Acute Coronary Events) risk score >140.1,2 In addition, early coronary computed tomographic angiography (CTA) may be used not only to rule out coronary artery disease, but also to stratify patients with NSTEACS into high risk categories due to the extent of obstructive coronary artery disease who may benefit from early revascularization.3,4 As a prespecified observational component of the VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial, coronary CTA blinded for the treating physicians was conducted before invasive coronary angiography. We tested the hypotheses that in patients with NSTEACS: 1) the extent of coronary pathology according to coronary CTA identifies patients at risk of adverse outcome independently from GRACE score; and 2) coronary CTA may identify patients in whom a very early invasive strategy is associated with improved clinical outcome.
Original languageEnglish
JournalJACC: Cardiovascular Imaging
Issue number10
Pages (from-to)1353-1355
Number of pages3
Publication statusPublished - 2023

ID: 371865489