• Eur Heart J Acute Cardiovasc Care · Nov 2020

    Randomized Controlled Trial Multicenter Study

    Role of coronary angiography in patients with a non-diagnostic electrocardiogram following out of hospital cardiac arrest: Rationale and design of the multicentre randomized controlled COUPE trial.

    • Ana Viana-Tejedor, Albert Ariza-Solé, Manuel Martínez-Sellés, Manuel Jiménez Mena, Montserrat Vila, Cosme García, J M García Acuña, Jordi Bañeras, Juan C García Rubira, Pablo J Pérez, Carlos T Querol, Gemma Pastor, Rut Andrea, Pablo L Osorio, Norberto Alonso, Cristina Martínez, María Pérez Rodríguez, Francisco J Noriega, Carlos Ferrera, Pablo Salinas, Iván Núñez Gil, Ortiz Antonio Fernández AF Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain., and Carlos Macaya.
    • Cardiology Department, Hospital Clínico San Carlos, Instituto de Investigación Sanitaria Hospital Clínico San Carlos (IdISSC), Madrid, Spain.
    • Eur Heart J Acute Cardiovasc Care. 2020 Nov 1; 9 (4_suppl): S131-S137.

    BackgroundCoronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA). The role of emergency coronary angiography (CAG) and percutaneous coronary intervention (PCI) following cardiac arrest in patients without ST-segment elevation myocardial infarction (STEMI) remains unclear.AimsWe aim to assess whether emergency CAG and PCI, when indicated, will improve survival with good neurological outcome in post-OHCA patients without STEMI who remain comatose.MethodsCOUPE is a prospective, multicentre and randomized controlled clinical trial. A total of 166 survivors of OHCA without STEMI will be included. Potentially non-cardiac aetiology of the cardiac arrest will be ruled out prior to randomization. Randomization will be 1:1 for emergency (within 2 h) or deferred (performed before discharge) CAG. Both groups will receive routine care in the intensive cardiac care unit, including therapeutic hypothermia. The primary efficacy endpoint is a composite of in-hospital survival free of severe dependence, which will be evaluated using the Cerebral Performance Category Scale. The safety endpoint will be a composite of major adverse cardiac events including death, reinfarction, bleeding and ventricular arrhythmias.ConclusionsThis study will assess the efficacy of an emergency CAG versus a deferred one in OHCA patients without STEMI in terms of survival and neurological impairment.

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