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

被引：13

作者：

Hauw-Berlemont, Caroline ^{[1
]}

Lamhaut, Lionel ^{[2
,3
,4
,5
]}

Diehl, Jean-Luc ^{[1
,6
]}

Andreotti, Christophe ^{[7
]}

Varenne, Olivier ^{[8
]}

Leroux, Pierre ^{[9
]}

Lascarrou, Jean-Baptiste ^{[10
]}

Guerin, Patrice ^{[11
]}

Loeb, Thomas ^{[12
]}

Roupie, Eric ^{[13
]}

Daubin, Cedric ^{[14
]}

Beygui, Farzin ^{[15
]}

Vilfaillot, Aurelie ^{[16
,17
]}

Glippa, Sophie ^{[16
,17
]}

Djadi-Prat, Juliette ^{[16
,17
]}

Chatellier, Gilles ^{[16
,17
]}

Cariou, Alain ^{[18
]}

Spaulding, Christian ^{[19
]}

机构：

[1] Paris Descartes Univ, European Hosp Georges Pompidou, AP HP, Med Intens Care Unit, Paris, France

[2] Paris Descartes Univ, Sorbonne Paris Cite Med Sch, Paris, France

[3] Hop Necker Enfants Malad, AP HP, Serv Aide Med Urgence 75, Paris, France

[4] INSERM, Team 4, U970, Paris, France

[5] Paris Cardiovasc Res Ctr, Paris, France

[6] Paris Univ, INSERM, UMR S1140, Paris, France

[7] Cochin Hosp, AP HP, Serv Mobile Urgence & Reanimat, Emergency Dept Cochin, Paris, France

[8] Cochin Hosp, Grp Hosp Cochin St Vincent de Paul Hotel Dieu, AP HP, Cardiol Dept,Intervent Cardiol, Paris, France

[9] Univ Hosp Nantes, Serv Aide Med Urgence SAMU 44, Nantes, France

[10] Univ Hosp Nantes, Med Intens Care Unit, Nantes, France

[11] Univ Hosp Nantes, Inst Thorax, Unite Homodynam, Nantes, France

[12] Hop Univ Paris Saclay, Serv Aide Med Urgence SAMU 92, Site Raymond Poincare, Garches, France

[13] Univ Hosp Caen, Serv Aide Med Urgence SAMU 14, Caen, France

[14] Univ Hosp Caen, Med Intens Care Unit, Caen, France

[15] Univ Hosp Caen, Cardiol Dept, Caen, France

[16] Hop Europeen Georges Pompidou, AP HP, INSERM, CIC 1418, Paris, France

[17] Hop Europeen Georges Pompidou, AP HP, Dept Informat Biostat & Sante Publ, Paris, France

[18] Ctr Univ Paris, Cochin Hosp, AP HP, Med Intens Care Unit,Med Sch, Paris, France

[19] Paris Descartes Univ, European Hosp Georges Pompidou, AP HP,Sudden Cardiac Death Expert Ctr, Cardiol Dept,INSERM,U971, F-75015 Paris, France

来源：

AMERICAN HEART JOURNAL | 2020年 / 222卷

关键词：

ST-SEGMENT ELEVATION; EUROPEAN-SOCIETY; HEART-DISEASE; ASSOCIATION; GUIDELINES; INSIGHTS; UPDATE; RESUSCITATION; INTERVENTION; RATIONALE;

D O I：

10.1016/j.ahj.2020.01.006

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

Background In adults, the most common cause of out-of-hospital cardiac arrests (OHCA) is acute coronary artery occlusion. If an immediate coronary angiogram (CAG) is recommended for survivors presenting a ST segment elevation on the electrocardiogram (ECG) performed after resuscitation, there is still a debate regarding the best strategy in patients without ST segment elevation. Hypothesis Performing an immediate CAG after an OHCA without ST segment elevation on the post-resuscitation ECG and no obvious non-cardiac cause of arrest could lead to a better 180-day survival rate with no or minimal neurological sequel as compared with a delayed CAG performed 48 to 96 hours after the arrest. Design The EMERGE trial is a prospective national, randomized, open and parallel group trial, in which 970 survivors of OHCA will be randomized (1:1) to either immediate (as soon as possible after return of spontaneous circulation) or delayed (48 to 96 h) CAG. Participants will be OHCA patients with no ST segment elevation on the post resuscitation ECG and no obvious non-cardiac cause of arrest. The primary endpoint of the study is the 180-day survival rate with no or minimal neurological sequel corresponding to Cerebral Performance Category (CPC) 1 or 2. The secondary endpoints are: occurrence of shock during the first 48 hours, ventricular tachycardia and/or fibrillation during the first 48 hours, change in left ventricular ejection fraction between baseline and 180 days assessed by echocardiogram, neurological status evaluated by the CPC score at intensive care unit (ICU) discharge and day 90 neurological status assessed by the Glasgow Outcome Scale Extended score (GOSE) at 90 and 180 days, overall survival rate, and hospital length of stay. Summary The EMERGE trial is a prospective, multicenter, randomized, controlled trial that will assess the 180-day survival rate with no or minimal neurologic sequel in patients resuscitated from an OHCA without ST segment elevation and who will be managed with either immediate or delayed CAG.

引用

页码：131 / 138

页数：8

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