TY - JOUR
T1 - Coronary CT Angiography as a Guide to Timing of Invasive Treatment in Patients With NSTEACS
AU - Kühl, Jørgen T.
AU - Kelbæk, Henning
AU - Linde, Jesper J.
AU - Sigvardsen, Per E.
AU - Hansen, Thomas F.
AU - de Knegt, Martina C.
AU - Heitmann, Merete
AU - Hansen, Peter R.
AU - Høfsten, Dan
AU - Bang, Lia E.
AU - Hove, Jens D.
AU - Kragelund, Charlotte
AU - Abdulla, Jawdat
AU - Holmvang, Lene
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Engstrøm, Thomas
AU - Køber, Lars V.
AU - Kofoed, Klaus F.
N1 - Funding Information:
This study was funded by the Danish Agency for Science, Technology, and Innovation and the Danish Council for Strategic Research (grant number 09-066994) and the Research Council of Rigshospitalet, Copenhagen, Denmark. Dr Linde has received grants from the Danish Research Foundation and the Research Council of Rigshospitalet during the conduct of the study. Dr Abdulla has received personal fees from Novartis Healthcare, outside of the submitted work. Dr Torp-Pedersen has received grants from Bayer, outside of the submitted work. Dr Engstrom has received personal fees from Abbott, AstraZeneca, Bayer, Boston Scientific, and Novo, outside of the submitted work. Dr Kober has received grants from the Danish Research Foundation during the conduct of the study. Dr Kofoed has received grants from Canon Medical Corp, outside of the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
PY - 2023
Y1 - 2023
N2 - 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.
AB - 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.
U2 - 10.1016/j.jcmg.2023.03.010
DO - 10.1016/j.jcmg.2023.03.010
M3 - Letter
C2 - 37178077
AN - SCOPUS:85164680529
VL - 16
SP - 1353
EP - 1355
JO - JACC. Cardiovascular imaging
JF - JACC. Cardiovascular imaging
SN - 1876-7591
IS - 10
ER -