• Blennow Nordström Erik E 0000-0003-1117-4412 Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Resea, Gisela Lilja, Susanna Vestberg, Susann Ullén, Hans Friberg, Niklas Nielsen, Katarina Heimburg, Lars Evald, Marco Mion, Magnus Segerström, Anders M Grejs, Thomas Keeble, Hans Kirkegaard, Hanna Ljung, Sofia Rose, Matthew P Wise, Christian Rylander, Johan Undén, and Tobias Cronberg.
• Lund University, Skane University Hospital, Center for Cardiac Arrest at Lund University, Neurology Research Unit, Department of Clinical Sciences Lund, Neurology, Remissgatan 4, 221 85, Lund, Sweden. erik.blennow_nordstrom@med.lu.se.
• Bmc Cardiovasc Disor. 2020 Oct 7; 20 (1): 439.

BackgroundThis study is designed to provide detailed knowledge on cognitive impairment after out-of-hospital cardiac arrest (OHCA) and its relation to associated factors, and to validate the neurocognitive screening of the Targeted Hypothermia versus Targeted Normothermia after Out-of-Hospital Cardiac Arrest trial (TTM2-trial), assessing effectiveness of targeted temperature management after OHCA.MethodsThis longitudinal multi-center clinical study is a sub-study of the TTM2-trial, in which a comprehensive neuropsychological examination is performed in addition to the main TTM2-trial neurocognitive screening. Approximately 7 and 24 months after OHCA, survivors at selected study sites are invited to a standardized assessment, including performance-based tests of cognition and questionnaires of emotional problems, fatigue, executive function and insomnia. At 1:1 ratio, a matched control group from a cohort of acute myocardial infarction (MI) patients is recruited to perform the same assessment. We aim to include 100 patients per group. Potential differences between the OHCA patients and the MI controls at 7 and 24 months will be analyzed with a linear regression, using composite z-scores per cognitive domain (verbal, visual/constructive, working memory, episodic memory, processing speed, executive functions) as primary outcome measures. Results from OHCA survivors on the main TTM2-trial neurocognitive screening battery will be compared with neuropsychological test results at 7 months, using sensitivity and specificity analyses.DiscussionIn this study we collect detailed information on cognitive impairment after OHCA and compare this to a control group of patients with acute MI. The validation of the TTM2 neurocognitive screening battery could justify its inclusion in routine follow-up. Our results may have a potential to impact on the design of future follow-up strategies and interventions after OHCA.Trial RegistrationClinicalTrials.gov, NCT03543371 . Registered 1 June 2018.

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