TY - JOUR
T1 - Coronary angiography after cardiac arrest: Rationale and design of the COACT trial
AU - Lemkes, Jorrit S.
AU - Janssens, Gladys N.
AU - Straaten, Heleen M. Oudemans-van
AU - Elbers, Paul W.
AU - van der Hoeven, Nina W.
AU - Tijssen, Jan G. P.
AU - Otterspoor, Luuk C.
AU - Voskuil, Michiel
AU - van der Heijden, Joris J.
AU - Meuwissen, Martijn
AU - Rijpstra, Tom A.
AU - Vlachojannis, Georgios J.
AU - van der Vleugel, Raoul M.
AU - Nieman, Koen
AU - Jewbali, Lucia S. D.
AU - Bleeker, Gabe B.
AU - Baak, Rémon
AU - Beishuizen, Bert
AU - Stoel, Martin G.
AU - van der Harst, Pim
AU - Camaro, Cyril
AU - Henriques, José P. S.
AU - Vink, Maarten A.
AU - Gosselink, Marcel T. M.
AU - Bosker, Hans A.
AU - Crijns, Harry J. G. M.
AU - van Royen, Niels
AU - Sleeker, Gabe B.
PY - 2016/10
Y1 - 2016/10
N2 - Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography (CAG) and percutaneous coronary intervention (PCI) after restoration of spontaneous circulation following cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains debated. We hypothesize that immediate CAG and PCI, if indicated, will improve 90-day survival in post-cardiac arrest patients without signs of STEMI. In a prospective, multicenter, randomized controlled clinical trial, 552 post-cardiac arrest patients with restoration of spontaneous circulation and without signs of STEMI will be randomized in a 1:1 fashion to immediate CAG and PCI (within 2 hours) versus initial deferral with CAG and PCI after neurological recovery. The primary end point of the study is 90-day survival. The secondary end points will include 90-day survival with good cerebral performance or minor/moderate disability, myocardial injury, duration of inotropic support, occurrence of acute kidney injury, need for renal replacement therapy, time to targeted temperature control, neurological status at intensive care unit discharge, markers of shock, recurrence of ventricular tachycardia, duration of mechanical ventilation, and reasons for discontinuation of treatment. The COACT trial is a multicenter, randomized, controlled clinical study that will evaluate the effect of an immediate invasive coronary strategy in post-cardiac arrest patients without STEMI on 90-day survival
AB - Ischemic heart disease is a major cause of out-of-hospital cardiac arrest. The role of immediate coronary angiography (CAG) and percutaneous coronary intervention (PCI) after restoration of spontaneous circulation following cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains debated. We hypothesize that immediate CAG and PCI, if indicated, will improve 90-day survival in post-cardiac arrest patients without signs of STEMI. In a prospective, multicenter, randomized controlled clinical trial, 552 post-cardiac arrest patients with restoration of spontaneous circulation and without signs of STEMI will be randomized in a 1:1 fashion to immediate CAG and PCI (within 2 hours) versus initial deferral with CAG and PCI after neurological recovery. The primary end point of the study is 90-day survival. The secondary end points will include 90-day survival with good cerebral performance or minor/moderate disability, myocardial injury, duration of inotropic support, occurrence of acute kidney injury, need for renal replacement therapy, time to targeted temperature control, neurological status at intensive care unit discharge, markers of shock, recurrence of ventricular tachycardia, duration of mechanical ventilation, and reasons for discontinuation of treatment. The COACT trial is a multicenter, randomized, controlled clinical study that will evaluate the effect of an immediate invasive coronary strategy in post-cardiac arrest patients without STEMI on 90-day survival
U2 - https://doi.org/10.1016/j.ahj.2016.06.025
DO - https://doi.org/10.1016/j.ahj.2016.06.025
M3 - Article
C2 - 27659881
SN - 0002-8703
VL - 180
SP - 39
EP - 45
JO - American Heart Journal
JF - American Heart Journal
ER -