Performance of Coronary CT Angiography to Rule Out Coronary Artery Disease After Out-of-hospital Cardiac Arrest

Not Applicable

Recruiting

• Conditions: Out of Hospital Cardiac Arrest Without ST-segment Elevation
• Interventions: Other: Coronary Calcium Score and Coronary CT angiogram

• Registration Number: NCT05961488
• Lead Sponsor: CHU de Reims

Brief Summary

Out-of-hospital cardiac arrest (OHCA) has multiple etiologies. In the absence of ST-elevation myocardial infarction, percutaneous coronary intervention (PCI) is delayed. This study aims to determine the diagnostic accuracy of Coronary Calcium Score (CCS) and Coronary CT Angiogram (CCTA) to rule out a coronary artery disease (CAD) in the first days after an OHCA.

Detailed Description

Each year, 50.000 out-of-hospital cardiac arrest (OHCA) occur in France. Acute myocardial infarction (AMI) is one of the most frequent etiology of OHCA. When a cardiac arrest is due to a ST-elevation myocardial infarction (STEMI), a percutaneous coronary intervention (PCI) is realized in emergency. However, without ST-elevation, PCI timing is unclear. 2020 European Society Recommandations suggest that PCI should not be realized in emergency, based on Lemkes and al. clinical trial. But there is scarce evidence about the exact timing to realize PCI. Electrocardiogram, troponin level, and echocardiography are unprecise to rule-out an ischemic etiology of cardiac arrest.

A brain CT-scan and a CT-pulmonary angiogram are recommended in first place, to identify the etiology of the cardiac arrest if there is no ST-elevation nor obvious causes. Nevertheless, in the absence of scanographic abnormality, a differed coronary angiogram should be realized.

We suggest that coronary CT angiogram (CCTA) and coronary calcium score (CCS) are feasible in the first days of hospitalization, and could rule-out a coronary artery disease (CAD). The aim of the study is to avoid an invasive coronary exploration, and to have a quick answer about anti-thrombotic treatments management.

Study Timeline

• Study First Submitted: 2023-07-18
• Study First Submitted QC: 2023-07-18
• Study First Posted: 2023-07-27
• Status Verified: 2024-03
• Study Start: 2024-03-04
• Last Update Submitted: 2024-03-05
• Last Update Posted: 2024-03-06
• Primary Completion: 2027-06
• Study Completion: 2028-01

Recruitment & Eligibility

• Status: RECRUITING
• Sex: All
• Target Recruitment: 200

Inclusion Criteria

Not provided

Exclusion Criteria

Not provided

Study & Design

• Study Type: INTERVENTIONAL
• Study Design: SINGLE_GROUP

Arm && Interventions

Group	Intervention	Description
Patients	Coronary Calcium Score and Coronary CT angiogram	-

Primary Outcome Measures

Name	Time	Method
Diagnostic accuracy of Coronary Computerized Tomographic Angiogram to rule-out a coronary stenosis > 50%	During hospitalization (maximum 7 days from ICU admission)

Secondary Outcome Measures

Name	Time	Method
Comparison of radiation dose between CCTA and percutaneous coronary intervention	During hospitalization (maximum 7 days from ICU admission)
Diagnostic accuracy of Coronary Computerized Tomographic Angiogram associated with Coronary Calcium Score compared to CCTA performance alone	During hospitalization (maximum 7 days from ICU admission)
Incidence of contrast associated acute kidney injury	Day 15
Diagnostic accuracy of Coronary Computerized Tomographic Angiogram to rule-out a coronary stenosis > 70%	During hospitalization (maximum 7 days from ICU admission)
Cororany calcium score associated with coronary stenosis between 50% and 70%	During hospitalization (maximum 7 days from ICU admission)
Comparison of contrast volume between CCTA and percutaneous coronary intervention	During hospitalization (maximum 7 days from ICU admission)

Trial Locations

Locations (1)

Damien JOLLY; 🇫🇷 Reims, France