Coronary angiography after cardiac arrest: Rationale and design of the COACT trial

Jorrit S Lemkes; Gladys N Janssens; Heleen M Oudemans-van Straaten; Paul W Elbers; Nina W van der Hoeven; Jan G P Tijssen; Luuk C Otterspoor; Michiel Voskuil; Joris J van der Heijden; Martijn Meuwissen; Tom A Rijpstra; Georgios J Vlachojannis; Raoul M van der Vleugel; Koen Nieman; Lucia S D Jewbali; Gabe B Bleeker; Rémon Baak; Bert Beishuizen; Martin G Stoel; Pim van der Harst; Cyril Camaro; José P S Henriques; Maarten A Vink; Marcel T M Gosselink; Hans A Bosker; Harry J G M Crijns; Niels van Royen

doi:10.1016/j.ahj.2016.06.025

Coronary angiography after cardiac arrest: Rationale and design of the COACT trial

Jorrit S Lemkes, Gladys N Janssens, Heleen M Oudemans-van Straaten, Paul W Elbers, Nina W van der Hoeven, Jan G P Tijssen, Luuk C Otterspoor, Michiel Voskuil, Joris J van der Heijden, Martijn Meuwissen, Tom A Rijpstra, Georgios J Vlachojannis, Raoul M van der Vleugel, Koen Nieman, Lucia S D Jewbali, Gabe B Bleeker, Rémon Baak, Bert Beishuizen, Martin G Stoel, Pim van der HarstCyril Camaro, José P S Henriques, Maarten A Vink, Marcel T M Gosselink, Hans A Bosker, Harry J G M Crijns, Niels van Royen,

Research output: Contribution to journal › Article › Academic › peer-review

Abstract

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 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, 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.

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.

Original language	English
Pages (from-to)	39-45
Number of pages	7
Journal	American Heart Journal
Volume	180
DOIs	https://doi.org/10.1016/j.ahj.2016.06.025
Publication status	Published - 2016

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Lemkes, J. S., Janssens, G. N., Straaten, H. M. O., Elbers, P. W., van der Hoeven, N. W., Tijssen, J. G. P., Otterspoor, L. C., Voskuil, M., van der Heijden, J. J., Meuwissen, M., Rijpstra, T. A., Vlachojannis, G. J., van der Vleugel, R. M., Nieman, K., Jewbali, L. S. D., Bleeker, G. B., Baak, R., Beishuizen, B., Stoel, M. G. (2016). Coronary angiography after cardiac arrest: Rationale and design of the COACT trial. American Heart Journal, 180, 39-45. https://doi.org/10.1016/j.ahj.2016.06.025

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title = "Coronary angiography after cardiac arrest: Rationale and design of the COACT trial",

abstract = "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 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, 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.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.",

author = "Lemkes, {Jorrit S} and Janssens, {Gladys N} and Straaten, {Heleen M Oudemans-van} and Elbers, {Paul W} and {van der Hoeven}, {Nina W} and Tijssen, {Jan G P} and Otterspoor, {Luuk C} and Michiel Voskuil and {van der Heijden}, {Joris J} and Martijn Meuwissen and Rijpstra, {Tom A} and Vlachojannis, {Georgios J} and {van der Vleugel}, {Raoul M} and Koen Nieman and Jewbali, {Lucia S D} and Bleeker, {Gabe B} and R{\'e}mon Baak and Bert Beishuizen and Stoel, {Martin G} and {van der Harst}, Pim and Cyril Camaro and Henriques, {Jos{\'e} P S} and Vink, {Maarten A} and Gosselink, {Marcel T M} and Bosker, {Hans A} and Crijns, {Harry J G M} and {van Royen}, Niels",

year = "2016",

doi = "10.1016/j.ahj.2016.06.025",

language = "English",

volume = "180",

pages = "39--45",

journal = "American Heart Journal",

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Lemkes, JS, Janssens, GN, Straaten, HMO, Elbers, PW, van der Hoeven, NW, Tijssen, JGP, Otterspoor, LC, Voskuil, M, van der Heijden, JJ, Meuwissen, M, Rijpstra, TA, Vlachojannis, GJ, van der Vleugel, RM, Nieman, K, Jewbali, LSD, Bleeker, GB, Baak, R, Beishuizen, B, Stoel, MG, van der Harst, P, Camaro, C, Henriques, JPS, Vink, MA, Gosselink, MTM, Bosker, HA, Crijns, HJGM, van Royen, N 2016, 'Coronary angiography after cardiac arrest: Rationale and design of the COACT trial', American Heart Journal, vol. 180, pp. 39-45. https://doi.org/10.1016/j.ahj.2016.06.025

TY - JOUR

T1 - Coronary angiography after cardiac arrest

T2 - 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

PY - 2016

Y1 - 2016

N2 - 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 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, 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.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.

AB - 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 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, 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.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.

U2 - 10.1016/j.ahj.2016.06.025

DO - 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 -

Coronary angiography after cardiac arrest: Rationale and design of the COACT trial

Abstract

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