Sensitive Troponin I in Out-of-hospital Cardiac Arrest

Study Overview
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Brief Summary
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Troponin is a major diagnostic criterion of acute myocardial infarction (AMI) which confirms myocardial damage and necrosis. In out-of-hospital cardiac arrest (OHCA) patients its dynamics and diagnostic value is often controversial and has not been well described. Most of prior studies were retrospective, using first generation troponin assays and assessing only admission troponin. The aim of this work is to correlate dynamics of sensitive troponin I with urgent coronary angiography. Patients resuscitated after OHCA will be prospectively divided in three groups based on the results of their urgent angiographies. Serial assessment of sensitive troponin I will be obtained over initial 48 hours. We expect admission troponin will not be predictive of AMI. Over next hours troponin levels will be highest in patients with acute coronary lesion, lower in stable obstructive coronary disease and insignificant in non-obstructive coronary disease. We also expect significant difference in highest values and dynamics of troponin in sub-group with spontaneous reperfusion (TIMI flow 2 and 3) comparing to patients with coronary occlusion (TIMI flow 0 and 1). In patients with non-obstructive disease we expect troponin levels to correlate with duration of cardiac arrest, number of external electric shocks and cumulative dose of adrenaline administered.

Official Title
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Sensitive Troponin I and Coronary Anatomy in Patients With Out-of-hospital Cardiac Arrest

Conditions
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Cardiac Arrest, Acute Coronary Lesion, Stable Obstructive Coronary Disease, Non-obstructive Coronary Disease

Intervention / Treatment
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* Other: Blood sample collection


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: female and male over 18 years old comatose survivors after out-of-hospital cardiac arrest (OHCA) absence of an obvious non-coronary cause urgent coronary angiography at admittance less than 3 hours from OHCA to first troponin assessment at admittance Exclusion Criteria: sub-acute myocardial infarction coronary spasms or in-stent thrombosis within first 48 hours after admission Coronary surgery or death within first 48 hours after admission

Ages Eligible for Study
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Minimum Age: 18 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Acute coronary syndrome culprit coronary lesion<br> | Other: Blood sample collection<br>* Eight blood samples in each patient within 48 hours to perform Troponin I measurement.<br>|
| Stable obstructive coronary artery disease<br> | Other: Blood sample collection<br>* Eight blood samples in each patient within 48 hours to perform Troponin I measurement.<br>|
| Non-obstructive coronary artery disease<br> | Other: Blood sample collection<br>* Eight blood samples in each patient within 48 hours to perform Troponin I measurement.<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Peak Troponin I value | Peak troponin I values will be compared among 3 groups with different coronary anatomy | Within 48 hours after hospital admission | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Admission troponin I value | Admission troponin I will be compared among 3 groups with different coronary anatomy | Within 3 hours of cardiac arrest | 
| Peak troponin I value in acute coronary syndrome group | Peak troponin I values will be compared among group with coronary artery occlusion and group with spontaneous reperfusion | Within 48 hours after hospital admission | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Cardiac arrest, Troponin I, coronary anatomy