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Lemkes, Jorrit S., MD; Janssens, Gladys N., MD; Straaten, Heleen M. Oudemans-van, MD, PhD; Elbers, Paul W., MD, PhD; van der Hoeven, Nina W., MD; Tijssen, Jan G.P., MD, PhD; Otterspoor, Luuk C., MD; Voskuil, Michiel, MD, PhD; van der Heijden, Joris J., MD; Meuwissen, Martijn, MD, PhD; Rijpstra, Tom A., MD; Vlachojannis, Georgios J., MD, PhD; van der Vleugel, Raoul M., MD; Nieman, Koen, MD, PhD; Jewbali, Lucia S.D., MD; Bleeker, Gabe B., MD, PhD; Baak, Rémon, MD; Beishuizen, Bert, MD, PhD; Stoel, Martin G., MD, PhD; van der Harst, Pim, MD, PhD; Camaro, Cyril, MD, PhD; Henriques, José P.S., MD, PhD; Vink, Maarten A., MD, PhD; Gosselink, Marcel T.M., MD, PhD; Bosker, Hans A; Crijns, Harry J.G.M., MD, PhD; van Royen, Niels, MD, PhD
The American heart journal, 10/2016, Letnik: 180Journal Article
Background 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 (ROSC), following cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) remains debated. Hypothesis We hypothesize that immediate CAG and PCI if indicated, will improve 90 day survival in post cardiac arrest patients without signs of STEMI. Design In a prospective, multi-centre, randomized controlled clinical trial, 552 post-cardiac arrest patients, with ROSC and without signs of STEMI will be randomized in a 1: 1 fashion to immediate CAG and PCI (within 2 hours) vs initial deferral with CAG and PCI after neurological recovery. The primary endpoint of the study is 90-day survival. The secondary endpoints will include 90 day survival with good, minor or 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 ICU discharge, markers of shock, recurrence of ventricular tachycardia, duration of mechanical ventilation and reasons for discontinuation of treatment. Summary 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.
