{"id":"af7eaf1388f4","type":"article","url":"https://hartvaat.nl/2020/02/11/ct-coronairangiografie-bij-nste-acs-verdict-cta-substudie/","title":"CT-coronairangiografie bij NSTE-ACS: VERDICT-CTA substudie","title_en":"Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["coronaire-ct-angiografie"],"journal":"Journal of the American College of Cardiology","doi":"10.1016/j.jacc.2019.12.012","source_url":"https://doi.org/10.1016/j.jacc.2019.12.012","authors":["Jesper J Linde","Henning Kelbæk","Thomas F Hansen","Per E Sigvardsen","Christian Torp-Pedersen","Jan Bech","Merete Heitmann","Olav W Nielsen","Dan Høfsten","Jørgen T Kühl","Ilan E Raymond","Ole P Kristiansen","Ida H Svendsen","Maria H D Vall-Lamora","Charlotte Kragelund","Martina de Knegt","Jens D Hove","Tem Jørgensen","Gitte G Fornitz","Rolf Steffensen","Birgit Jurlander","Jawdat Abdulla","Stig Lyngbæk","Hanne Elming","Susette K Therkelsen","Erik Jørgensen","Lene Kløvgaard","Lia Evi Bang","Peter Riis Hansen","Steffen Helqvist","Søren Galatius","Frants Pedersen","Ulrik Abildgaard","Peter Clemmensen","Kari Saunamäki","Lene Holmvang","Thomas Engstrøm","Gunnar Gislason","Lars V Køber","Klaus F Kofoed"],"significance":6,"published":"2020-02-11","source_date":"2020-02-11","image":"","kennis":[],"congress":"","summary_en":"This VERDICT substudy evaluated coronary CT angiography in NSTE-ACS patients, assessing whether non-invasive anatomical imaging can guide the management approach in acute coronary syndromes.","created":"2026-07-03T10:28:25Z","updated":"2026-07-03T13:27:35Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"VERDICT substudie naar de rol van CCTA bij patiënten met NSTE-ACS.","abstract_original":"BACKGROUND: In patients with non-ST-segment elevation acute coronary syndrome (NSTEACS), coronary pathology may range from structurally normal vessels to severe coronary artery disease. OBJECTIVES: The purpose of this study was to test if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS. METHODS: The VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes) trial (NCT02061891) evaluated the outcome of patients with confirmed NSTEACS randomized 1:1 to very early (within 12 h) or standard (48 to 72 h) invasive coronary angiography (ICA). As an observational component of the trial, a clinically blinded coronary CTA was conducted prior to ICA in both groups. The primary endpoint was the ability of coronary CTA to rule out coronary artery stenosis (≥50% stenosis) in the entire population, expressed as the negative predictive value (NPV), using ICA as the reference standard. RESULTS: Coronary CTA was conducted in 1,023 patients-very early, 2.5 h (interquartile range [IQR]: 1.8 to 4.2 h), n = 583; and standard, 59.9 h (IQR: 38.9 to 86.7 h); n = 440 after the diagnosis of NSTEACS was made. A coronary stenosis ≥50% was found by coronary CTA in 68.9% and by ICA in 67.4% of the patients. Per-patient NPV of coronary CTA was 90.9% (95% confidence interval [CI]: 86.8% to 94.1%) and the positive predictive value, sensitivity, and specificity were 87.9% (95% CI: 85.3% to 90.1%), 96.5% (95% CI: 94.9% to 97.8%) and 72.4% (95% CI: 67.2% to 77.1%), respectively. NPV was not influenced by patient characteristics or clinical risk profile and was similar in the very early and the standard strategy group. CONCLUSIONS: Coronary CTA has a high diagnostic accuracy to rule out clinically significant coronary artery disease in patients with NSTEACS."}