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EMCrit Podcast 243 – The COACT Trial on Early vs. Delayed Cath after Cardiac Arrest without STEMI


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Hot off the press is the COACT trial randomizing patients to immediate vs. delayed cardiac catheterization after cardiac arrest. I had this on my list to do a 'cast on, but EMCrit Team Member Felipe Teran beat me to it. He interviews past show guest and the lead author of the editorial on the paper, Ben Abella. The trial only included patients with an initial shockable rhythm and they were still unconscious. STEMIs went right to the lab.
COACT Trial

* Actual Paper1
* Editorial2

This comes right at the heels of the AHA statement by Yannopoulos et al. recommending a more aggressive stance on immediate cath.3
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1.
Lemkes JS, Janssens GN, van der Hoeven NW, et al. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. N Engl J Med. March 2019. doi:10.1056/nejmoa1816897




2.
Abella BS, Gaieski DF. Coronary Angiography after Cardiac Arrest — The Right Timing or the Right Patients? N Engl J Med. March 2019. doi:10.1056/nejme1901651




3.
Yannopoulos D, Bartos JA, Aufderheide TP, et al. The Evolving Role of the Cardiac Catheterization Laboratory in the Management of Patients With Out-of-Hospital Cardiac Arrest: A Scientific Statement From the American Heart Association. Circulation. 2019;139(12). doi:10.1161/cir.0000000000000630



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EMCrit FOAM FeedBy Scott D. Weingart, MD FCCM

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