Cite this post as:
Scott Weingart, MD FCCM. EMCrit Podcast 243 – The COACT Trial on Early vs. Delayed Cath after Cardiac Arrest without STEMI. EMCrit Blog. Published on March 31, 2019. Accessed on February 3rd 2023. Available at [https://emcrit.org/emcrit/coact-trial/ ].
Financial Disclosures:
Dr. Scott Weingart, Course Director, reports no relevant financial relationships with ineligible companies.
This episode’s speaker(s), (listed above), report no relevant financial relationships with ineligible companies.
CME Review
Original Release: March 31, 2019
Date of Most Recent Review: Jan 1, 2022
Termination Date: Jan 1, 2025
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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?… Read more »
Can I only serve to help bridge the internet gaps between great thinkers. Check out Dr Smith’s EKG blog for his example of COACT gone wrong. https://hqmeded-ecg.blogspot.com/2020/11/a-woman-in-her-60s-with-vfib-arrest-and.html In short, because STEMI vs NSTEMI is a flawed paradox, other EKG markers of OMI may be ignored. To quote Dr Smith Blog: This study had a fatal flaw: they did not keep track of all the “Non-STEMI patients” who were NOT enrolled, but instead were sent for immediate angiogram. It was done in Europe, where the guidelines suggest taking all shockable arrests emergently to the cath lab. So it is highly likely that physicians were very… Read more »