heart attack non-ST elevation acute coronary syndrome
Conditions
Interventions
Diagnosis
Patients in the intervention group will undergo a coronary CT angiography.
Acute coronary syndrome
High-sensitivity troponins
Sponsors
Erasmus MC, Universitair Medisch Centrum Rotterdam
Eligibility
Age
18 Years to 64 Years
Inclusion criteria
Inclusion criteria: Patients eligible for inclusion are aged between 30 and 80 years and present to the emergency department with symptoms suggestive of non-ST elevation acute coronary syndrome. These patients have a normal or non-diagnostic ECG. High-sensitivity levels are slightly elevated but under the limit for definitive diagnosis of acute myocardial infarction. During serial sampling there is no more than 40% rise or fall.
Exclusion criteria
Exclusion criteria: Inability or unwillingness to provide informed consent. History of proven CAD, defined as documented prior myocardial infarction, percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery. Previous examination with either invasive angiography or CCTA in the last 3 years. Clinical instability: clinical heart failure, hemodynamic instability, severe chest pain. CCTA¬-specific contra¬indications: o Allergy to iodine contrast media o Pregnancy o Impaired renal function: estimated glomerular filtering rate 40 kg/m2 o Inability to cooperate during the examination.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| The negative predictive value of CCTA for NSTE-ACS. | — |
Secondary
| Measure | Time frame |
|---|---|
| 1) Predictive value of CCTA for major cardiac adverse events: death, non-fatal myocardial infarction and coronary revascularisation at 6 months. 2) Determine the prevalence of atherosclerosis, extent and type and correlate with clinical factors. 3) Potential benefit of FFR-CT in the diagnosis of NSTE-ACS. | — |
Countries
The Netherlands
Outcome results
None listed