# CT-coronairangiografie bij NSTE-ACS: VERDICT-CTA substudie

*geplaatst 2020-02-11 · Algemeen · Journal of the American College of Cardiology · doi 10.1016/j.jacc.2019.12.012 · https://hartvaat.nl/2020/02/11/ct-coronairangiografie-bij-nste-acs-verdict-cta-substudie/*

VERDICT substudie naar de rol van CCTA bij patiënten met NSTE-ACS.

## English: Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome.

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.

## Abstract (original, from the publication)

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.

Auteurs: 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

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Bron: Journal of the American College of Cardiology, https://doi.org/10.1016/j.jacc.2019.12.012. Bijgewerkt 2026-07-03T13:27:35Z. 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.