Coronary angiography after cardiac arrest

Rationale: The clinical benefit of acute coronary angiography following return of spontaneous circulation (ROSC) in patients without an ST segment elevation myocardial infarction after out of hospital cardiac arrest (OHCA) is unclear.
Objective: Aim of this study is to compare a strategy of immediate coronary angiography followed by percutaneous coronary intervention (PCI) if indicated with delayed coronary angiography in patients presenting at the emergency department after out of hospital cardiac arrest without signs of a ST segment elevation myocardial infarction (STEMI) and no obvious non-cardiac aetiology. Primary endpoint is survival until 90 days.
Study design: The study is a prospective, randomized controlled, multi-centre study.
Study population: The research population will be recruited from the general patient population presenting with return of spontaneous circulation after out of hospital cardiac arrest without signs of a ST segment elevation myocardial infarction, at the emergency department. A total of 552 consecutive patients will be included.
Intervention (if applicable): The patients will be randomized to either the immediate or delayed coronary angiography and subsequent revascularisation group.
Main study parameters/endpoints: The primary end point of the study is 90-days survival Secondary endpoints are 90-days survival with good, minor or moderate disability, myocardial injury measured by troponine and CK MB as area under the curve, occurrence off acute kidney injury, need for renal replacement therapy, time to target hypothermia, neurological status at ICU discharge, duration of inotropic support, markers of shock,,, recurrence of ventriculair tachycardia, duration of mechanical ventilation and reason for discontinuation of treatment.

Acute coronary angiography and PCI will improve 90 day survival in patients after cardiac arrest and without signs of STEMI.

01-12-2014 start inrollment
01-12-2017 final inrollment
01-03-2018 end of follow up.

The patients will be randomized to either the immediate or delayed coronary angiography and subsequent revascularisation group.