Overview
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
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
- 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