Evidence map›Paper›PMID 35656797›Full record

Trial reportEuropean heart journal. Acute cardiovascular care2022

Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction: a COACT trials' post-hoc subgroup analysis.

Eva M Spoormans, Jorrit S Lemkes, Gladys N Janssens, Ouissal Soultana, Nina W van der Hoeven, Lucia S D Jewbali, Eric A Dubois, Martijn Meuwissen, Tom A Rijpstra, Hans A Bosker and 28 more

Abstract readClinical Trial
In one paragraph

Trial report in European heart journal. Acute cardiovascular care, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

38 authors.

Eva M SpoormansDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Jorrit S LemkesDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.ORCID 0000-0001-7993-8680
Gladys N JanssensDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Ouissal SoultanaDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Nina W van der HoevenDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.
Lucia S D JewbaliDepartment of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Eric A DuboisDepartment of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands.
Martijn MeuwissenDepartment of Cardiology, Amphia Hospital, Breda, The Netherlands.ORCID 0000-0002-5421-5205
Tom A RijpstraDepartment of Intensive Care Medicine, Amphia Hospital, Breda, The Netherlands.
Hans A BoskerDepartment of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands.
Michiel J BlansDepartment of Intensive Care Medicine, Rijnstate Hospital, Arnhem, The Netherlands.
Gabe B BleekerDepartment of Cardiology, HAGA Hospital, Den Haag, The Netherlands.
Remon BaakDepartment of Intensive Care Medicine, HAGA Hospital, Den Haag, The Netherlands.
Georgios J VlachojannisDepartment of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands.
Bob J W EikemansDepartment of Intensive Care Medicine, Maasstad Hospital, Rotterdam, The Netherlands.
Pim van der HarstDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Iwan C C van der HorstDepartment of Intensive Care Medicine, University of Groningen, University Medical Centre Groningen, Groningen, The Netherlands.
Michiel VoskuilDepartment of Cardiology, University Medical Centre Utrecht, Utrecht, The Netherlands.
Joris J van der HeijdenDepartment of Intensive Care Medicine, University Medical Centre Utrecht, Utrecht, The Netherlands.
Albertus BeishuizenIntensive Care Centre, Medisch Spectrum Twente, Enschede, The Netherlands.
Martin StoelDepartment of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands.
Cyril CamaroDepartment of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.ORCID 0000-0001-6170-8318
Hans van der HoevenDepartment of Intensive Care Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands.
José P HenriquesDepartment of Cardiology, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands.
Alexander P J VlaarDepartment of Intensive Care Medicine, Amsterdam University Medical Centre, location AMC, Amsterdam, The Netherlands.
Maarten A VinkDepartment of Cardiology, OLVG, Amsterdam, The Netherlands.
Bas van den BogaardDepartment of Intensive Care Medicine, OLVG, Amsterdam, The Netherlands.
Ton A C M HeestermansDepartment of Cardiology, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands.
Wouter de RuijterDepartment of Intensive Care Medicine, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands.
Thijs S R DelnoijDepartment of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands.
Harry J G M CrijnsDepartment of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands.
Pranobe V OemrawsinghDepartment of Cardiology, Haaglanden Medical Centre, Den Haag, The Netherlands.
Marcel T M GosselinkDepartment of Cardiology, Isala Hospital, Zwolle, The Netherlands.
Koos PlompDepartment of Cardiology, Tergooi Hospital, Blaricum, The Netherlands.
Michael MagroDepartment of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands.ORCID 0000-0002-0581-3532
Paul W G ElbersDepartment of Intensive care medicine, Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands.
Peter M van de VenDepartment of Epidemiology and Data Science, Amsterdam University Medical Centre, location VUmc, Amsterdam, The Netherlands.
Niels van RoyenDepartment of Cardiology, Amsterdam University Medical Centre, location VUmc, ZH 5F 19, De Boelelaan 1117, 1081 HV Amsterdam, The Netherlands.

Funding

Netherlands Heart Institute, Biotronik, and AstraZeneca
6 · The paper itself

Abstract

aimsST-depression and T-wave inversion are frequently present on the post-resuscitation electrocardiogram (ECG). However, the prognostic value of ischaemic ECG patterns is unknown. METHODS AND

resultsIn this post-hoc subgroup analysis of the Coronary Angiography after Cardiac arrest (COACT) trial, the first in-hospital post-resuscitation ECG in out-of-hospital cardiac arrest patients with a shockable rhythm was analysed for ischaemic ECG patterns. Ischaemia was defined as ST-depression of ≥0.1 mV, T-wave inversion in ≥2 contiguous leads, or both. The primary endpoint was 90-day survival. Secondary endpoints were rate of acute unstable lesions, levels of serum troponin-T, and left ventricular function. Of the 510 out-of-hospital cardiac arrest patients, 340 (66.7%) patients had ischaemic ECG patterns. Patients with ischaemic ECG patterns had a worse 90-day survival compared with those without [hazard ratio 1.51; 95% confidence interval (CI) 1.08-2.12; P = 0.02]. A higher sum of ST-depression was associated with lower survival (log-rank = 0.01). The rate of acute unstable lesions (14.5 vs. 15.8%; odds ratio 0.90; 95% CI 0.51-1.59) did not differ between the groups. In patients with ischaemic ECG patterns, maximum levels of serum troponin-T (μg/L) were higher [0.595 (interquartile range 0.243-1.430) vs. 0.359 (0.159-0.845); ratio of geometric means 1.58; 1.13-2.20] and left ventricular function (%) was worse (44.7 ± 12.5 vs. 49.9 ± 13.3; mean difference -5.13; 95% CI -8.84 to -1.42). Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival.

conclusionPost-arrest ischaemic ECG patterns were associated with worse 90-day survival. A higher sum of ST-depression was associated with lower survival. Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival.

Indexed as

Out-of-Hospital Cardiac ArrestST Elevation Myocardial InfarctionCoronary AngiographyElectrocardiographyHumansTroponin TTroponin TCardiac arrestECGIschaemiaLeft ventricular functionShockable rhythm

Identifiers

PMID35656797
PMCPMC9302930

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.