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

  title={Coronary angiography after cardiac arrest: Rationale and design of the COACT trial.},
  author={Jorrit S Lemkes and Gladys Nathalia Janssens and Heleen M. Oudemans-van Straaten and Paul W. G. Elbers and Nina Willemijn van der Hoeven and Jan G. P. Tijssen and Luuk C Otterspoor and Michiel D. Voskuil and Joris J. van der Heijden and Martijn Meuwissen and Tom A Rijpstra and Georgios J. Vlachojannis and Raoul M van der Vleugel and Koen Nieman and Lucia S Jewbali and Gabe B. Bleeker and R{\'e}mon Baak and Bert Beishuizen and Martin G. Stoel and Pim van der Harst and Cyril Camaro and Jos{\'e} P S Henriques and Maarten A. Vink and Marcel T.M. Gosselink and Hans A. Bosker and Harry J.G.M. Crijns and Niels van Royen},
  journal={American heart journal},

Coronary Angiography after Cardiac Arrest without ST‐Segment Elevation

A strategy of immediate angiography was not found to be better than a strategy of delayedAngiography with respect to overall survival at 90 days among patients who had been successfully resuscitated after out‐of‐hospital cardiac arrest and had no signs of STEMI.

Coronary Angiography After Cardiac Arrest Without ST Segment Elevation: One-Year Outcomes of the COACT Randomized Clinical Trial.

In this trial of patients successfully resuscitated after out-of-hospital cardiac arrest and without signs of STEMI, a strategy of immediate angiography was not found to be superior to a strategy with respect to clinical outcomes at 1 year, andCoronary angiographic in this patient group can therefore be delayed until after neurologic recovery without affecting outcomes.

Out-of-hospital cardiac arrest: always coronary angiography?

Immediate coronary intervention in the setting of OHCA appears to be associated with better survival to discharge; the documentation of an occluded coronary artery in medium 25% of patients without signs of STEMI at ECG helps to explain why early angiography can improve outcomes.

Predictors of coronary artery disease in cardiac arrest survivors: coronary angiography for everyone? A single-center retrospective analysis

In patients with cardiac arrest, ST-segment elevation, wall motion abnormalities, left ventricular dysfunction and elevated high sensitivity troponin T were predictive of coronary artery disease, and it was not possible to establish the best cutoff for coronary angiography timing.

Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms

Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs non-shockable group.

Infarct-related chronic total coronary occlusion and the risk of ventricular tachyarrhythmic events in out-of-hospital cardiac arrest survivors

In out-of-hospital cardiac arrest survivors with coronary artery disease without ST-segment elevation, an IRA-CTO was not an independent factor associated with VTEs in the 1st year after the index event.



Immediate coronary angiography in survivors of out-of-hospital cardiac arrest.

Acute coronary-artery occlusion is frequent in survivors of out-of-hospital cardiac arrest and is predicted poorly by clinical and electrocardiographic findings, but accurate diagnosis by immediate coronary angiography can be followed in suitable candidates by coronary angioplasty, which seems to improve survival.

Immediate versus deferred coronary angioplasty in non-ST-segment elevation acute coronary syndromes

Immediate PCI was associated with an increased rate of MI as compared to a 24-48 hours deferred strategy, in spite of an aggressive antithrombotic treatment, and the results suggest that PCI for high-risk, non-refractory NSTE-ACS should be delayed for at least 24 hours after hospital admission.

Survival in patients without acute ST elevation after cardiac arrest and association with early coronary angiography: a post hoc analysis from the TTM trial

In this post hoc observational study of a large randomized trial, early coronary angiography for patients without acute ST elevation after out-of-hospital cardiac arrest of a presumed cardiac cause was not associated with improved survival.

Immediate vs delayed intervention for acute coronary syndromes: a randomized clinical trial.

In patients with acute coronary syndromes without ST-segment elevation, a strategy of immediate intervention compared with an intervention deferred to the next working day did not result in a difference in myocardial infarction as defined by peak troponin level.

Emergency coronary angiography in comatose cardiac arrest patients: do real-life experiences support the guidelines?

In comatose survivors of OHCA presenting with STEMI, a high prevalence of coronary disease and culprit lesions suitable for emergency PCI was found, whereas in patients without STEMI pattern, significant coronary stenosis was less frequent.

Post Cardiac Arrest Syndrome: A Review of Therapeutic Strategies

This review focuses on therapeutic strategies and recent developments in managing patients who are initially resuscitated from cardiac arrest, which ideally follows from the implementation of basic and advanced life support measures, including effective cardiopulmonary resuscitation and defibrillation when appropriate.

Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European association for percutaneous cardiovascular interventions (EAPCI)/stent for life (SFL) groups.

  • M. NocJ. Fajadet C. Spaulding
  • Medicine
    EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology
  • 2014
Experts from the EAPCI and "Stent for Life" groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia.

Impact of routine percutaneous coronary intervention after out-of-hospital cardiac arrest due to ventricular fibrillation

It is suggested that routine coronary angiography with potentially associated PCI may favorably alter the prognosis of resuscitated patients with stable hemodynamics who are treated with MTH after out-of-hospital cardiac arrest related to ventricular fibrillation.