ECG-less gated cardiac CT to detect coronary blockages after cardiac arrest without ST-elevation

Is this trial a fit for you?

A plain-English reading of the study's rules. Only the study team can confirm whether you qualify.

What this trial studies

This interventional diagnostic study enrolls adults with sustained return of spontaneous circulation after in- or out-of-hospital cardiac arrest who do not have ST-elevation myocardial infarction. Participants who are stable enough for imaging will undergo an ECG-less gated cardiac CT scan to visualize the coronary arteries using iodinated contrast. Findings on the CT will be compared to invasive coronary angiography or clinical outcomes to determine diagnostic accuracy for acute culprit lesions. Patients with hemodynamic or electrical instability, VA-ECMO, clear STEMI, or contraindications to contrast are excluded, and informed consent is obtained from the patient or a representative prior to invasive angiography.

Why it matters

Who can join: the full rules

* Inclusion:

  * Adults (≥18 years) with sustained return of spontaneous circulation (ROSC) following in/out-of-hospital cardiac arrest.
  * Informed consent from patient or representative obtained before invasive coronary angiography.
* Exclusion

  * Patients on VA-ECMO
  * ACS STEMI or STEMI "equivalent"

    * New left/right bundle branch block
    * ST segment depression in leads V1-V3, when the terminal T wave is positive and concomitant ST-segment elevation ≥ 0,5mm recorded in leads V7-V9 (posterior MI)
    * ST-segment elevation in V7-V9 (posterior MI) or V3R-V4R (RV MI)
  * ACS NSTEMI with persistent ST depression despite optimal therapy, suggesting ongoing myocardial ischemia, with indication for an urgent ICA according to the treating physician.
  * Hemodynamic/electrical instability precluding CT imaging (as perceived by the treating physician)
  * Life-threatening arrhythmia potentially caused by acute myocardial ischemia
  * Absolute contraindications to iodinated contrast
  * Patients with a known non-cardiac cause of cardiac arrest (e.g., traumatic brain injury, overt hemorrhage, asphyxia/severe hypoxia due to known lung disease, trauma, severe metabolic/electrolyte derangement, or intoxication) as perceived by the treating physician, where chest CT is considered unnecessary.
  * Known or likely pregnancy or lactation
  * Severe bleeding issue (as perceived by the treating physician) precluding heparin administration during radial access coronary angiography.
  * Prior coronary intervention (stent implantation/CABG).
  * CT findings indicating a condition that precludes coronary angiography in the short term.
  * Patients with end-of-life care pathways.
  * Participation in another intervention study interfering with the research questions in OPEN CCT Arrest.

Where it's running

• Universitair Ziekenhuis Brussel (UZB)
  Brussels, Vlaams Brabant, Belgium Recruiting

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How to take part

1. Review the eligibility criteria above with your treating physician.
2. Check the official listing on ClinicalTrials.gov for the latest contact details and recruitment status.
3. Contact the study coordinator or principal investigator to ask for pre-screening. Pre-screening is free and never obligates you to enroll.