EMERGEncy versus delayed coronary angiogram in survivors of out-of-hospital cardiac arrest with no obvious non-cardiac cause of arrest: Design of the EMERGE trial

Hauw‐Berlemont, Caroline; Lamhaut, Lionel; Diehl, Jean‐Luc; Andreotti, Christophe; Varenne, Olivier; Leroux, Pierre; Lascarrou, Jean-Baptiste; Guérin, Patrice; Loeb, Thomas; Roupie, É.; Daubin, Cédric; Beygui, Farzin; Vilfaillot, Aurélie; Glippa, Sophie; Djadi-Prat, Juliette; Châtellier, Gilles; Cariou, Alain; Spaulding, Christian; investigators, Emerge

doi:10.1016/j.ahj.2020.01.006

Cited by 19 publications

(17 citation statements)

References 31 publications

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“…Finally, the number of patients with non-shockable initial rhythm and no ST-elevation with ACS in our population is too small to accurately estimate their mortality. However, this is due to the low prevalence of the ACS in this population, therefore a more powerful estimation of mortality should be performed in larger future studies, some ongoing, including patients without post-resuscitation ST-elevation 26 .…”

Section: Discussionmentioning

confidence: 99%

Immediate coronary angiogram in out-of-hospital cardiac arrest patients with non-shockable initial rhythm and without ST-segment elevation — Is there a clinical benefit?

et al. 2020

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Section: Discussionmentioning

confidence: 99%

Immediate coronary angiogram in out-of-hospital cardiac arrest patients with non-shockable initial rhythm and without ST-segment elevation — Is there a clinical benefit?

et al. 2020

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“…Several randomized clinical trials are still ongoing [ 29 , 30 , 31 , 32 , 33 ]. Results from pilot studies from the DISCO (Direct or subacute coronary angiography in out-of-hospital cardiac arrest), ARREST trial (A randomized trial of expedited transfer to a cardiac arrest center for non-STE ventricular fibrillation OHCA) and from the prematurely terminated PEARL trial (Early coronary angiography versus delayed coronary angiography) are already available and confirmed no significant difference in mortality between early and delayed CAG in OHCA without STE ( Table 1 ).…”

Section: Clinical Studiesmentioning

confidence: 99%

Percutaneous Coronary Revascularization after Out-of-Hospital Cardiac Arrest: A Review of the Literature and a Case Series

Scavelli

Cartella

Montalto

et al. 2022

JCM

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Out-of-hospital cardiac arrest (OHCA) is still associated with high mortality and severe complications, despite major treatment advances in this field. Ischemic heart disease is a common cause of OHCA, and current guidelines clearly recommend performing immediate coronary angiography (CAG) in patients whose post-resuscitation electrocardiogram shows ST-segment elevation (STE). Contrarily, the optimal approach and the advantage of early revascularization in cases of no STE is less clear, and decisions are often based on the individual experience of the center. Numerous studies have been conducted on this topic and have provided contradictory evidence; however, more recently, results from several randomized clinical trials have suggested that performing early CAG has no impact on overall survival in patients without STE.

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“…Further outcome data concerning long-term mortality as well as additional determinants from the COACT trial are to be expected. Currently, several randomised trials are ongoing and will provide more comprehensive data in selecting the appropriate candidates for immediate coronary angiography [ 48 – 50 ]. The Direct or Subacute Coronary Angiography in Out-of-Hospital Cardiac Arrest (DISCO) study is assigning resuscitated patients irrespective of initial rhythm in the absence of STE, to either immediate coronary angiography (<2 h) or standard strategy (according to current practice in the participating hospitals, preferably not during the initial 3 days) [ 48 ].…”

Section: Upcoming Trialsmentioning

confidence: 99%

The role of coronary angiography in out-of-hospital cardiac arrest patients in the absence of ST-segment elevation: A literature review

et al. 2020

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Out-of-hospital cardiac arrest (OHCA) is a major cause of death. Although the aetiology of cardiac arrest can be diverse, the most common cause is ischaemic heart disease. Coronary angiography and percutaneous coronary intervention, if indicated, has been associated with improved long-term survival for patients with initial shockable rhythm. However, in patients without ST-segment elevation on the postresuscitation electrocardiogram, the optimal timing of performing this invasive procedure is uncertain. One important challenge that clinicians face is to appropriately select patients that will benefit from immediate coronary angiography, yet avoid unnecessary delay of intensive care support and targeted temperature management. Observational studies have reported contradictory results and until recently, randomised trials were lacking. The Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) was the first randomised trial that provided comparative information between coronary angiography treatment strategies. This literature review will provide the current knowledge and gaps in the literature regarding optimal care for patients successfully resuscitated from OHCA in the absence of ST-segment elevation and will primarily focus on the role and timing of coronary angiography in this high-risk patient population.

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EMERGEncy versus delayed coronary angiogram in survivors of out-of-hospital cardiac arrest with no obvious non-cardiac cause of arrest: Design of the EMERGE trial

Cited by 19 publications

References 31 publications

Immediate coronary angiogram in out-of-hospital cardiac arrest patients with non-shockable initial rhythm and without ST-segment elevation — Is there a clinical benefit?

Immediate coronary angiogram in out-of-hospital cardiac arrest patients with non-shockable initial rhythm and without ST-segment elevation — Is there a clinical benefit?

Percutaneous Coronary Revascularization after Out-of-Hospital Cardiac Arrest: A Review of the Literature and a Case Series

The role of coronary angiography in out-of-hospital cardiac arrest patients in the absence of ST-segment elevation: A literature review

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