• Caroline Hauw-Berlemont, Lionel Lamhaut, Jean-Luc Diehl, Christophe Andreotti, Olivier Varenne, Pierre Leroux, Lascarrou Jean-Baptiste JB Medical Intensive Care Unit, University Hospital of Nantes, Nantes, France., Patrice Guerin, Thomas Loeb, Eric Roupie, Cédric Daubin, Farzin Beygui, Aurélie Vilfaillot, Sophie Glippa, Juliette Djadi-Prat, Gilles Chatellier, Alain Cariou, Christian Spaulding, and EMERGE investigators.
• Medical Intensive Care Unit, European Hospital Georges Pompidou, Assitance Publique-Hôpitaux de Paris, Paris Descartes University, Paris, France.
• Am. Heart J. 2020 Apr 1; 222: 131-138.

BackgroundIn 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.HypothesisPerforming 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.DesignThe 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.SummaryThe 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.Copyright © 2020 Elsevier Inc. All rights reserved.

32 keywords...

hide…