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
ResusTEE Course
Easily the best resuscitative TEE/TOE course I have ever seen. Just pure goodness.
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Now on to the Podcast…
Podcast: Play in new window | Download (Duration: 21:26 — 20.0MB) | Embed
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Does this reflect, to some degree, the variation in practice between the Netherlands and the US. I.e. in the studied patients there were few “Intervenable lesions”. We know that if you take 10 cardiologists, show them a cath you will get 20 different opinions on whether a lesion is “intervenable”. At this point, I think the validity of this study may be supported by this issue. Will be interested to see if the next few RCTs show the same outcomes. Then… We will be very interested in the behavior of the AHA writing group. Will they bend to RCT data? or will they bend to their financial interests?
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