NCT02641626

Brief Summary

Prospective, multicenter, randomized clinical trial. Survivors from an out-of-hospital cardiac arrest (OHCA) without ST segment elevation in their EKG will be recruited. Potentially non-cardiac etiology of the cardiac arrest will be ruled out prior to randomization. Primary goal (treatment): to evaluate the efficacy of urgent vs deferred coronary angiography in survivors from OHCA without ST-segment elevation in the EKG.

Trial Health

87
On Track

Trial Health Score

Automated assessment based on enrollment pace, timeline, and geographic reach

Enrollment
72

participants targeted

Target at P50-P75 for not_applicable

Timeline
Completed

Started Jan 2016

Longer than P75 for not_applicable

Geographic Reach
1 country

1 active site

Status
completed

Health score is calculated from publicly available data and should be used for screening purposes only.

Trial Relationships

Click on a node to explore related trials.

Study Timeline

Key milestones and dates

First Submitted

Initial submission to the registry

December 20, 2015

Completed
9 days until next milestone

First Posted

Study publicly available on registry

December 29, 2015

Completed
3 days until next milestone

Study Start

First participant enrolled

January 1, 2016

Completed
5.1 years until next milestone

Primary Completion

Last participant's last visit for primary outcome

January 31, 2021

Completed
Same day until next milestone

Study Completion

Last participant's last visit for all outcomes

January 31, 2021

Completed
Last Updated

August 30, 2021

Status Verified

August 1, 2021

Enrollment Period

5.1 years

First QC Date

December 20, 2015

Last Update Submit

August 24, 2021

Conditions

Keywords

cardiac arrestsurvivalneurologic prognosiscoronariographyhypothermia

Outcome Measures

Primary Outcomes (4)

  • Survival with good neurological outcome for activities of daily living (CPC 1-2).

    Survival with good neurological outcome for activities of daily living (CPC 1-2).

    30 days.

  • Survival with good neurological outcome for activities of daily living (CPC 1-2).

    Survival with good neurological outcome for activities of daily living (CPC 1-2).

    6 months.

  • MACE: death, myocardial infarction, clinically evident bleeding (BARC> 2) or ventricular arrhythmias.

    MACE: death, myocardial infarction, clinically evident bleeding (BARC\> 2) or ventricular arrhythmias.

    30 days.

  • MACE: death, myocardial infarction, clinically evident bleeding (BARC> 2) or ventricular arrhythmias.

    MACE: death, myocardial infarction, clinically evident bleeding (BARC\> 2) or ventricular arrhythmias.

    6 months.

Secondary Outcomes (16)

  • Hospital survival.

    30 days.

  • Hospital survival.

    6 months.

  • Neurological outcome assessed by the Cerebral Performance Category (CPC) Scale.

    30 days.

  • Neurological outcome assessed by the Cerebral Performance Category (CPC) Scale.

    6 months.

  • Left ventricular ejection fraction.

    30 days.

  • +11 more secondary outcomes

Study Arms (2)

Urgent Coronary Angiography

EXPERIMENTAL

Urgent Coronary Angiography: as soon as possible, when the patient is randomized.

Procedure: Urgent Coronary Angiography

Deferred coronariography

ACTIVE COMPARATOR

Deferred coronary angiography: after extubation if the patient has a good neurologic prognosis.

Procedure: Deferred Coronary Angiography

Interventions

Diagnostic test for the evaluation of the coronary vasculature.

Urgent Coronary Angiography

Diagnostic test for the evaluation of the coronary vasculature.

Deferred coronariography

Eligibility Criteria

Age18 Years+
Sexall
Healthy VolunteersNo
Age GroupsAdult (18-64), Older Adult (65+)

You may qualify if:

  • Remain comatose after recovery of spontaneous circulation (ROSC) (Glasgow Coma Scale score equal or less than 8).
  • Show a non-diagnostic electrocardiogram after ROSC (neither ST segment elevation nor left bundle branch block).
  • Prior rule out of an obvious non-cardiac cause of the cardiac arrest (head CT scan and transthoracic echocardiogram).

You may not qualify if:

  • Age \<18 years.
  • Pregnant women or women of childbearing age unless they have a negative pregnancy test.
  • Time to return of spontaneous circulation longer than 60 minutes.
  • Non-cardiac etiology of the comatose state: drug overdose, head injury or stroke.
  • Acute myocardial infarction with ST segment elevation or left bundle branch block, because in those patients emergent angiography is mandatory.
  • Hemodynamic instability (refractory cardiogenic shock despite vasoactive drugs or refractory arrhythmias), because in those patients an emergent angiography is mandatory.
  • Known coagulopathy or bleeding.
  • Refusal to participate in the study by the next of kin.

Contact the study team to confirm eligibility.

Sponsors & Collaborators

Study Sites (1)

Hospital Clínico San Carlos

Madrid, 28040, Spain

Location

Related Publications (3)

  • Camuglia AC, Randhawa VK, Lavi S, Walters DL. Cardiac catheterization is associated with superior outcomes for survivors of out of hospital cardiac arrest: review and meta-analysis. Resuscitation. 2014 Nov;85(11):1533-40. doi: 10.1016/j.resuscitation.2014.08.025. Epub 2014 Sep 4.

  • Morrison LJ, Neumar RW, Zimmerman JL, Link MS, Newby LK, McMullan PW Jr, Hoek TV, Halverson CC, Doering L, Peberdy MA, Edelson DP; American Heart Association Emergency Cardiovascular Care Committee, Council on Cardiopulmonary, Critical Care, Perioperative and Resuscitation, Council on Cardiovascular and Stroke Nursing, Council on Clinical Cardiology, and Council on P. Strategies for improving survival after in-hospital cardiac arrest in the United States: 2013 consensus recommendations: a consensus statement from the American Heart Association. Circulation. 2013 Apr 9;127(14):1538-63. doi: 10.1161/CIR.0b013e31828b2770. Epub 2013 Mar 11. No abstract available.

  • Viana-Tejedor A, Andrea-Riba R, Scardino C, Ariza-Sole A, Baneras J, Garcia-Garcia C, Jimenez Mena M, Vila M, Martinez-Selles M, Pastor G, Garcia Acuna JM, Loma-Osorio P, Garcia Rubira JC, Jorge Perez P, Pastor P, Ferrera C, Noriega FJ, Perez Macias N, Fernandez-Ortiz A, Perez-Villacastin J; COUPE Investigators. Coronary angiography in patients without ST-segment elevation following out-of-hospital cardiac arrest. COUPE clinical trial. Rev Esp Cardiol (Engl Ed). 2023 Feb;76(2):94-102. doi: 10.1016/j.rec.2022.05.013. Epub 2022 Jun 22. English, Spanish.

MeSH Terms

Conditions

Heart ArrestHypothermia

Condition Hierarchy (Ancestors)

Heart DiseasesCardiovascular DiseasesBody Temperature ChangesSigns and SymptomsPathological Conditions, Signs and Symptoms

Study Officials

  • Ana Viana Tejedor, MD, PhD

    Hospital Clinico San Carlos

    PRINCIPAL INVESTIGATOR

Study Design

Study Type
interventional
Phase
not applicable
Allocation
RANDOMIZED
Masking
NONE
Purpose
TREATMENT
Intervention Model
PARALLEL
Sponsor Type
OTHER
Responsible Party
PRINCIPAL INVESTIGATOR
PI Title
MD. PhD

Study Record Dates

First Submitted

December 20, 2015

First Posted

December 29, 2015

Study Start

January 1, 2016

Primary Completion

January 31, 2021

Study Completion

January 31, 2021

Last Updated

August 30, 2021

Record last verified: 2021-08

Locations