Platelets in out of Hospital Cardiac ARrest (PoHCAR) project
Research type
Research Study
Full title
A pilot investigation of coagulation and platelet function in the era of modern antiplatelet therapy and targeted temperature management for the treatment of acute coronary events after out of hospital cardiac arrest.
IRAS ID
199298
Contact name
Agnieszka Skorko
Contact email
Sponsor organisation
UHBristol Education and Research Centre
Duration of Study in the UK
0 years, 5 months, 0 days
Research summary
An out of hospital cardiac arrest (OHCA) is a sudden catastrophic event, most commonly as a result of a heart attack; an ST elevation myocardial infarction (STEMI) due to clot formation in a coronary artery. STEMI treatment requires rapid restoration of blood flow through the blocked artery, performed by percutaneous coronary intervention (PCI) and stent insertion. In order to prevent re-clotting of this stent antiplatelet medications (DAPTs) are given.
The timing and dose of DAPTs given to OHCA survivors are based on evidence extrapolated from non-OHCA patients, and this data may not be transferrable. Data suggests that blood after OHCA may be in a pro-clotting state. Additionally, we have a number of reasons to suppose that the DAPTs may not actually work effectively after OHCA and so expose the survivor to life threatening clotting complication such as in-stent thrombosis.
The need to prevent clots needs to be balance against the risk of bleeding. OHCA patients undergo a number of interventions that increase their risk of serious bleeding. Chief amongst these is medical hypothermia which is vital to minimise brain injury but is known to increase bleeding risk.
The primary aim of this study is therefore to check how blood clots and platelets work in survivors of OHCA. A maximum of 5 blood tests will be taken to test these; one will be taken at hospital admission (before any DAPT is given), one after PCI and one each at 12, 24 and 48 hours after PCI.
As a comparison, the same clotting and platelet tests will be measured in STEMI patients who undergo PCI but have not suffered a cardiac arrest.
Data will also be collected on complication rates in each group over the first 30 day after recruitment.
REC name
Wales REC 7
REC reference
16/WA/0161
Date of REC Opinion
27 May 2016
REC opinion
Favourable Opinion