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Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

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Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. / Linde, Jesper J; Kelbæk, Henning; Hansen, Thomas F; Sigvardsen, Per E; Torp-Pedersen, Christian; Bech, Jan; Heitmann, Merete; Nielsen, Olav W; Høfsten, Dan; Kühl, Jørgen T; Raymond, Ilan E; Kristiansen, Ole P; Svendsen, Ida H; Vall-Lamora, Maria H D; Kragelund, Charlotte; de Knegt, Martina; Hove, Jens D; Jørgensen, Tem; Fornitz, Gitte G; Steffensen, Rolf; Jurlander, Birgit; Abdulla, Jawdat; Lyngbæk, Stig; Elming, Hanne; Therkelsen, Susette K; Jørgensen, Erik; Kløvgaard, Lene; Bang, Lia Evi; Hansen, Peter Riis; Helqvist, Steffen; Galatius, Søren; Pedersen, Frants; Abildgaard, Ulrik; Clemmensen, Peter; Saunamäki, Kari; Holmvang, Lene; Engstrøm, Thomas; Gislason, Gunnar; Køber, Lars V; Kofoed, Klaus F.

In: J AM COLL CARDIOL, Vol. 75, No. 5, 11.02.2020, p. 453-463.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Linde, JJ, Kelbæk, H, Hansen, TF, Sigvardsen, PE, Torp-Pedersen, C, Bech, J, Heitmann, M, Nielsen, OW, Høfsten, D, Kühl, JT, Raymond, IE, Kristiansen, OP, Svendsen, IH, Vall-Lamora, MHD, Kragelund, C, de Knegt, M, Hove, JD, Jørgensen, T, Fornitz, GG, Steffensen, R, Jurlander, B, Abdulla, J, Lyngbæk, S, Elming, H, Therkelsen, SK, Jørgensen, E, Kløvgaard, L, Bang, LE, Hansen, PR, Helqvist, S, Galatius, S, Pedersen, F, Abildgaard, U, Clemmensen, P, Saunamäki, K, Holmvang, L, Engstrøm, T, Gislason, G, Køber, LV & Kofoed, KF 2020, 'Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome', J AM COLL CARDIOL, vol. 75, no. 5, pp. 453-463. https://doi.org/10.1016/j.jacc.2019.12.012

APA

Linde, J. J., Kelbæk, H., Hansen, T. F., Sigvardsen, P. E., Torp-Pedersen, C., Bech, J., Heitmann, M., Nielsen, O. W., Høfsten, D., Kühl, J. T., Raymond, I. E., Kristiansen, O. P., Svendsen, I. H., Vall-Lamora, M. H. D., Kragelund, C., de Knegt, M., Hove, J. D., Jørgensen, T., Fornitz, G. G., ... Kofoed, K. F. (2020). Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. J AM COLL CARDIOL, 75(5), 453-463. https://doi.org/10.1016/j.jacc.2019.12.012

Vancouver

Linde JJ, Kelbæk H, Hansen TF, Sigvardsen PE, Torp-Pedersen C, Bech J et al. Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome. J AM COLL CARDIOL. 2020 Feb 11;75(5):453-463. https://doi.org/10.1016/j.jacc.2019.12.012

Bibtex

@article{3ff961b36a2142639035707e0f380f59,
title = "Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome",
abstract = "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.",
keywords = "Acute Coronary Syndrome/diagnostic imaging, Aged, Computed Tomography Angiography, Coronary Angiography, Coronary Stenosis/diagnostic imaging, Female, Humans, Male, Middle Aged, Predictive Value of Tests, Prospective Studies",
author = "Linde, {Jesper J} and Henning Kelb{\ae}k and Hansen, {Thomas F} and Sigvardsen, {Per E} and Christian Torp-Pedersen and Jan Bech and Merete Heitmann and Nielsen, {Olav W} and Dan H{\o}fsten and K{\"u}hl, {J{\o}rgen T} and Raymond, {Ilan E} and Kristiansen, {Ole P} and Svendsen, {Ida H} and Vall-Lamora, {Maria H D} and Charlotte Kragelund and {de Knegt}, Martina and Hove, {Jens D} and Tem J{\o}rgensen and Fornitz, {Gitte G} and Rolf Steffensen and Birgit Jurlander and Jawdat Abdulla and Stig Lyngb{\ae}k and Hanne Elming and Therkelsen, {Susette K} and Erik J{\o}rgensen and Lene Kl{\o}vgaard and Bang, {Lia Evi} and Hansen, {Peter Riis} and Steffen Helqvist and S{\o}ren Galatius and Frants Pedersen and Ulrik Abildgaard and Peter Clemmensen and Kari Saunam{\"a}ki and Lene Holmvang and Thomas Engstr{\o}m and Gunnar Gislason and K{\o}ber, {Lars V} and Kofoed, {Klaus F}",
note = "Copyright {\textcopyright} 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.",
year = "2020",
month = feb,
day = "11",
doi = "10.1016/j.jacc.2019.12.012",
language = "English",
volume = "75",
pages = "453--463",
journal = "J AM COLL CARDIOL",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "5",

}

RIS

TY - JOUR

T1 - Coronary CT Angiography in Patients With Non-ST-Segment Elevation Acute Coronary Syndrome

AU - Linde, Jesper J

AU - Kelbæk, Henning

AU - Hansen, Thomas F

AU - Sigvardsen, Per E

AU - Torp-Pedersen, Christian

AU - Bech, Jan

AU - Heitmann, Merete

AU - Nielsen, Olav W

AU - Høfsten, Dan

AU - Kühl, Jørgen T

AU - Raymond, Ilan E

AU - Kristiansen, Ole P

AU - Svendsen, Ida H

AU - Vall-Lamora, Maria H D

AU - Kragelund, Charlotte

AU - de Knegt, Martina

AU - Hove, Jens D

AU - Jørgensen, Tem

AU - Fornitz, Gitte G

AU - Steffensen, Rolf

AU - Jurlander, Birgit

AU - Abdulla, Jawdat

AU - Lyngbæk, Stig

AU - Elming, Hanne

AU - Therkelsen, Susette K

AU - Jørgensen, Erik

AU - Kløvgaard, Lene

AU - Bang, Lia Evi

AU - Hansen, Peter Riis

AU - Helqvist, Steffen

AU - Galatius, Søren

AU - Pedersen, Frants

AU - Abildgaard, Ulrik

AU - Clemmensen, Peter

AU - Saunamäki, Kari

AU - Holmvang, Lene

AU - Engstrøm, Thomas

AU - Gislason, Gunnar

AU - Køber, Lars V

AU - Kofoed, Klaus F

N1 - Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

PY - 2020/2/11

Y1 - 2020/2/11

N2 - 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.

AB - 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.

KW - Acute Coronary Syndrome/diagnostic imaging

KW - Aged

KW - Computed Tomography Angiography

KW - Coronary Angiography

KW - Coronary Stenosis/diagnostic imaging

KW - Female

KW - Humans

KW - Male

KW - Middle Aged

KW - Predictive Value of Tests

KW - Prospective Studies

U2 - 10.1016/j.jacc.2019.12.012

DO - 10.1016/j.jacc.2019.12.012

M3 - SCORING: Journal article

C2 - 32029126

VL - 75

SP - 453

EP - 463

JO - J AM COLL CARDIOL

JF - J AM COLL CARDIOL

SN - 0735-1097

IS - 5

ER -