Current evaluation of patients suspected of non-ST-elevation acute coronary syndrome is greatly dictated by the results of high-sensitivity troponins. In a substantial number of patients this approach does not provide a conclusive work-up. Patients typically present with slightly elevated high-sensitivity troponins without significant changes during serial sampling and no other clinical clues that can aid in determining the etiology of their chest pain complaints. Uncertainty remains about the optimal diagnostic management of these patients and they are often admitted to undergo invasive angiography. Coronary CT angiography can improve efficiency of clinical care in these patients by reducing unnecessary hospital admissions and invasive angiography. In this study, the investigators will investigate whether a diagnostic strategy comprising of early coronary CT angiography is more clinically efficient than standard optimal care in patients with an inconclusive work-up for non-ST-elevation acute coronary syndrome.
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
230
Coronary CT angiography
Amphia ziekenhuis
Breda, North Brabant, Netherlands
RECRUITINGErasmus MC
Rotterdam, South Holland, Netherlands
RECRUITINGDiagnostic accuracy of coronary CT angiography to identify patients with NSTE-ACS.
Sensitivity and specificity of coronary CT angiography for the diagnosis of NSTE-ACS.
Time frame: 30 day
Potential improvement of diagnostic accuracy with FFR-CT.
Off-line calculation of FFR-CT will be performed and the diagnostic accuracy for NSTE-ACS will be determined and compared to conventional coronary CT angiography.
Time frame: 30 day
Clinical characteristics of no obstructive coronary artery disease on CT.
To determine which clinical characteristics are predictive of not having obstructive coronary artery disease on CT.
Time frame: 30 day
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