Coronary Computed Tomography Versus Invasive Angiography for Non-ST Elevation Acute Coronary Syndrome
Trial Parameters
Brief Summary
Coronary computed tomography angiography (CCTA) is a widely accepted initial diagnostic test for individuals suspected of having chronic coronary syndromes. However, there is limited evidence supporting its use in the acute setting. So far, no large-scale randomized trial has examined the performance of CCTA as an alternative to invasive coronary angiography (ICA) in individuals with non-ST-segment elevation myocardial infarction (NSTEACS). If CCTA were to replace ICA as a routine procedure for individuals with NSTEACS, it could reduce the risk of complications related to ICA, improve patient comfort, expedite decision-making, and reduce healthcare expenses and interhospital transfers.
Eligibility Criteria
Inclusion criteria: * Admitted with non-ST-segment elevation myocardial infarction or unstable angina pectoris and an indication for subacute ICA * Elevated troponin or ischemic electrocardiographic changes * Written informed consent Exclusion criteria: * Instability requiring acute or emergent ICA * History of percutaneous coronary intervention or coronary artery bypass grafting * Estimated glomerular filtration rate \< 30 mL/min/1.73m2 * Probable type 2 acute myocardial infarction * Severe valvular heart disease as primary diagnosis or potential need for valve intervention * History of spontaneous coronary artery dissection * Expected poor quality of the CCTA * Prior CCTA or ICA during index admission or within 1 week * Known allergy to beta-blockers or contrast agent * Pregnant or nursing * Previously randomized in this trial