Role of coronary angiography in patients with a non-diagnostic electrocardiogram following out of hospital cardiac arrest: Rationale and design of the multicentre randomized controlled COUPE trial
Por:
Viana-Tejedor, A, Ariza-Sole, A, Martinez-Selles, M, Mena, MJ, Vila, M, Garcia, C, Acuna, JMG, Baneras, J, Rubira, JCG, Perez, PJ, Querol, CT, Pastor, G, Andrea, R, Osorio, PL, Alonso, N, Martinez, C, Rodriguez, MP, Noriega, FJ, Ferrera, C, Salinas, P, Gil, IN, Ortiz, AF and Macaya, C
Publicada:
1 nov 2020
Ahead of Print:
25 jun 2019
Resumen:
Background: Coronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA). The role of emergency coronary angiography (CAG) and percutaneous coronary intervention (PCI) following cardiac arrest in patients without ST-segment elevation myocardial infarction (STEMI) remains unclear.
Aims: We aim to assess whether emergency CAG and PCI, when indicated, will improve survival with good neurological outcome in post-OHCA patients without STEMI who remain comatose.
Methods: COUPE is a prospective, multicentre and randomized controlled clinical trial. A total of 166 survivors of OHCA without STEMI will be included. Potentially non-cardiac aetiology of the cardiac arrest will be ruled out prior to randomization. Randomization will be 1:1 for emergency (within 2 h) or deferred (performed before discharge) CAG. Both groups will receive routine care in the intensive cardiac care unit, including therapeutic hypothermia. The primary efficacy endpoint is a composite of in-hospital survival free of severe dependence, which will be evaluated using the Cerebral Performance Category Scale. The safety endpoint will be a composite of major adverse cardiac events including death, reinfarction, bleeding and ventricular arrhythmias.
Conclusions: This study will assess the efficacy of an emergency CAG versus a deferred one in OHCA patients without STEMI in terms of survival and neurological impairment.
Filiaciones:
Viana-Tejedor, A:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Ariza-Sole, A:
Hosp Univ Bellvitge, Cardiol Dept, Barcelona, Spain
Martinez-Selles, M:
Univ Europea, Univ Complutense, CIBERCV, Cardiol Dept,Hosp Gen Univ Gregorio Maranon, Madrid, Spain
Mena, MJ:
Hosp Univ Ramon y Cajal, Cardiol Dept, Madrid, Spain
Vila, M:
Hosp Santa Creu & Sant Pau, Fundacio Inst Recerca, Cardiol Dept, Barcelona, Spain
:
Hosp Badalona Germans Trias & Pujol, CIBERCV, Cardiol Dept, Barcelona, Spain
Acuna, JMG:
Hosp Univ Santiago De Compostela, CIBERCV, Cardiol Dept, Santiago De Compostela, Spain
Baneras, J:
Hosp Univ Vall dHebron, CIBERCV, Cardiol Dept, Barcelona, Spain
Rubira, JCG:
Hosp Virgen de la Macarena, Cardiol Dept, Seville, Spain
Perez, PJ:
Hosp Univ Canarias, Cardiol Dept, Tenerife, Spain
Querol, CT:
Hosp Arnau Vilanova, Lleida IRBLL, Cardiol Dept, Lleida, Spain
Pastor, G:
Hosp Clin Univ Valladolid, CIBERCV, Cardiol Dept, Valladolid, Spain
Andrea, R:
Univ Barcelona, Inst Invest Mediques Pi & Sunyer, IDIBAPS, Inst Cardiovasc,Hosp Clin, Barcelona, Spain
Osorio, PL:
CIBERCV, Inst Invest Biomed Dr Josep Trueta Girona, Cardiol Dept, Girona, Spain
Alonso, N:
Hosp Univ Leon, Cardiol Dept, Leon, Spain
Martinez, C:
Hosp Univ Principe Asturias, Intens Care Med Dept, Madrid, Spain
Rodriguez, MP:
Hosp Univ Tarragona Joan XXIII, Cardiol Dept, Tarragona, Spain
Noriega, FJ:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Ferrera, C:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Salinas, P:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Gil, IN:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Ortiz, AF:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
Macaya, C:
Hosp Clin San Carlos, Cardiol Dept, Inst Invest Sanitaria Hosp Clin San Carlos IdISSC, Madrid, Spain
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