Utility of CT coronary angiography in non-ST elevation acute coronary syndrome

By Syed Ghias

Take Home Messages

  • Coronary computed tomographic angiography (CCTA) is a well-established non-invasive diagnostic modality which reliably rules out obstructive coronary artery disease in patients with chronic coronary syndrome.
  • CCTA is now also recommended as an alternative diagnostic strategy to invasive angiography to exclude ACS when there is a low-to-intermediate likelihood of coronary artery disease.
  • Although CCTA demonstrates high diagnostic performance in patients with non-ST elevation acute coronary syndrome, a strategy of routine CCTA makes little difference to treatment decisions or 1-year clinical outcomes when compared with standard care in intermediate-to-high-risk patients with chest pain and suspected acute coronary syndrome.
  • The real utility of CCTA could lie in its ability to be used as rapid ‘rule- in’ test in the emergency department thereby reducing the rate of downstream testing and the duration of antithrombotic medical therapy in patients without significant CAD.

Read the full BCS Editorial here