ECG-less gated cardiac CT to detect coronary blockages after cardiac arrest without ST-elevation
Diagnostic Accuracy of ECG-less Gated Cardiac CT in Resuscitated Cardiac Arrest Survivors
This test will see if ECG-less gated cardiac CT can find narrowed or blocked coronary arteries in adults who were resuscitated from cardiac arrest but do not have ST-elevation on their ECG.
Quick facts
| Phase | Not applicable |
|---|---|
| Study type | Interventional |
| Enrollment | 30 (estimated) |
| Ages | 18 Years and up |
| Sex | All |
| Sponsor | Universitair Ziekenhuis Brussel Academic / other |
| Locations | 1 site (Brussels, Vlaams Brabant) |
| Trial ID | NCT07388342 on ClinicalTrials.gov |
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.
Who should consider this trial
Good fit: Adults aged 18 or older with sustained ROSC after in- or out-of-hospital cardiac arrest who do not have ST-elevation, are stable enough for CT imaging, and can provide consent or have a representative consent.
Not a fit: Patients with STEMI or STEMI equivalents, ongoing ischemia requiring urgent angiography, hemodynamic/electrical instability, VA-ECMO support, or contraindications to iodinated contrast are unlikely to benefit from this CT-based diagnostic approach.
Why it matters
Potential benefit: If successful, this approach could help identify which resuscitated patients without ST-elevation have treatable coronary blockages and reduce unnecessary urgent invasive angiography.
How similar studies have performed: Prior research shows coronary CT angiography can accurately detect coronary artery disease in stable patients, but its diagnostic role specifically in resuscitated non-STEMI cardiac arrest patients is relatively novel and not yet established.
Eligibility criteria
Show full inclusion / exclusion criteria
* 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 this trial is running
Brussels, Vlaams Brabant
- Universitair Ziekenhuis Brussel (UZB) — Brussels, Vlaams Brabant, Belgium (Recruiting)
How to participate
- Review the eligibility criteria above with your treating physician.
- Visit the official trial page on ClinicalTrials.gov for the most current contact information and recruitment status.
- Contact the listed study coordinator or principal investigator to request pre-screening. Pre-screening is free and never obligates you to enroll.