CCTA has high diagnostic accuracy in NSTEACS patients: VERDICT Trial

Denmark: Coronary artery disease can be accurately ruled out in patients presenting with non-ST-segment elevation acute coronary syndrome (NSTEACS) with the use of coronary CT angiography (CTA), suggests findings from the VERDICT trial. This would spare some patients from subsequent testing and admission and would help to pinpoint the patients more likely to benefit from revascularization. 

Findings of the study, published in the Journal of the American College of Cardiology, suggests that in patients with NSTEACS, coronary CTA can be conducted within 2 h of clinical diagnosis to quickly identify patients in whom invasive evaluation will be futile. 

Current guidelines favor invasive angiography as the primary diagnostic test for patients with ACS, whereas coronary CTA is reserved for those with chest pain who have an intermediate pretest likelihood of CAD. However, up to one-third of these higher-risk patients sent for cath are found not to have obstructive disease, the authors from the current study point out. 

Jesper J. Linde, Department of Cardiology, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark, and colleagues tested if coronary computed tomography angiography (CTA) may be used to exclude coronary artery stenosis ≥50% in patients with NSTEACS in the VERDICT (Very Early Versus Deferred Invasive Evaluation Using Computerized Tomography in Patients With Acute Coronary Syndromes).