Format

Send to

Choose Destination
Eur Heart J Acute Cardiovasc Care. 2019 Jun 25:2048872618813843. doi: 10.1177/2048872618813843. [Epub ahead of print]

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.

Author information

1
1 Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
2
2 Cardiology Department, Hospital Universitari de Bellvitge, Barcelona, Spain.
3
3 Cardiology Department, Hospital General Universitario Gregorio Marañón, CIBERCV, Universidad Complutense, Universidad Europea, Madrid, Spain.
4
4 Cardiology Department, Hospital Universitario Ramón y Cajal, Madrid, Spain.
5
5 Cardiology Department, Fundació Institut de Recerca de l'Hospital de la Santa Creu i Sant Pau, Barcelona, Spain.
6
6 Cardiology Department, Hospital Universitari Germans Trias i Pujol, CIBERCV, Barcelona, Spain.
7
7 Cardiology Department, Hospital Universitario de Santiago de Compostela, CIBERCV, Spain.
8
8 Cardiology Department, Hospital Universitario Vall d'Hebron, CIBERCV, Barcelona, Spain.
9
9 Cardiology Department, Hospital Virgen de la Macarena, Seville, Spain.
10
10 Cardiology Department, Hospital Universitario de Canarias, Tenerife, Spain.
11
11 Cardiology Department, Hospital Universitari Arnau de Vilanova, Lleida - IRBLL, Lleida, Spain.
12
12 Cardiology Department, Hospital Clínico Universitario de Valladolid, CIBERCV, Valladolid, Spain.
13
13 Instituto Cardiovascular, Hospital Clinic, IDIBAPS, Universidad de Barcelona, Institut de Investigacions Mèdiques Pi i Sunyer, Spain.
14
14 Cardiology Department, Institut d Investigación Biomedica Dr. Josep Trueta de Girona, CIBERCV, Girona, Spain.
15
15 Cardiology Department, Hospital Universitario de León, Spain.
16
16 Intensive Care Medicine Department, Hospital Universitario Príncipe de Asturias, Madrid, Spain.
17
17 Cardiology Department. Hospital Universitari de Tarragona Joan XXIII. Tarragona, Spain.

Abstract

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.

KEYWORDS:

Out-of-hospital cardiac arrest; coronary angiography; neurological outcome; non-diagnostic electrocardiogram; percutaneous coronary intervention; survival

PMID:
31237435
DOI:
10.1177/2048872618813843

Supplemental Content

Full text links

Icon for Atypon
Loading ...
Support Center