PMID- 30092413
OWN - NLM
STAT- MEDLINE
DCOM- 20190625
LR  - 20240320
IS  - 1097-6744 (Electronic)
IS  - 0002-8703 (Linking)
VI  - 204
DP  - 2018 Oct
TI  - Rationale and design of: A Randomized tRial of Expedited transfer to a cardiac 
      arrest center for non-ST elevation out-of-hospital cardiac arrest: The ARREST 
      randomized controlled trial.
PG  - 92-101
LID - S0002-8703(18)30218-7 [pii]
LID - 10.1016/j.ahj.2018.06.016 [doi]
AB  - BACKGROUND: Out-of-hospital cardiac arrest (OHCA) is a global public health 
      issue. There is wide variation in both regional and inter-hospital survival rates 
      from OHCA and overall survival remains poor at 7%. Regionalization of care into 
      cardiac arrest centers (CAC) improves outcomes following cardiac arrest from ST 
      elevation myocardial infarction (STEMI) through concentration of services and 
      greater provider experience. The International Liaison Committee on Resuscitation 
      (ILCOR) recommends delivery of all post-arrest patients to a CAC, but that 
      randomized controlled trials are necessary in patients without ST elevation 
      (STE). METHODS/DESIGN: Following completion of a pilot randomized trial to assess 
      safety and feasibility of conducting a large-scale randomized controlled trial in 
      patients following OHCA of presumed cardiac cause without STE, we present the 
      rationale and design of A Randomized tRial of Expedited transfer to a cardiac 
      arrest center for non-ST elevation OHCA (ARREST). In total 860 patients will be 
      enrolled and randomized (1:1) to expedited transfer to CAC (24/7 access to 
      interventional cardiology facilities, cooling and goal-directed therapies) or to 
      the current standard of care, which comprises delivery to the nearest emergency 
      department. Primary outcome is 30-day all-cause mortality and secondary outcomes 
      are 30-day and 3-month neurological status and 3, 6 and 12-month mortality. 
      Patients will be followed up for one year after enrolment. CONCLUSION: 
      Post-arrest care is time-critical, requires a multi-disciplinary approach and may 
      be more optimally delivered in centers with greater provider experience. This 
      trial would help to demonstrate if regionalization of post-arrest care to CACs 
      reduces mortality in patients without STE, which could dramatically reshape 
      emergency care provision.
CI  - Copyright (c) 2018 Elsevier Inc. All rights reserved.
FAU - Patterson, Tiffany
AU  - Patterson T
AD  - Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, 
      King's College London, St. Thomas' Hospital, London, UK. Electronic address: 
      tiffanypatterson05@gmail.com.
FAU - Perkins, Alexander
AU  - Perkins A
AD  - London School of Hygiene and Tropical Medicine Clinical Trials Unit, London, UK.
FAU - Perkins, Gavin D
AU  - Perkins GD
AD  - Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, Warwick 
      Medical School, University of Warwick, Coventry, UK.
FAU - Clayton, Tim
AU  - Clayton T
AD  - London School of Hygiene and Tropical Medicine Clinical Trials Unit, London, UK.
FAU - Evans, Richard
AU  - Evans R
AD  - London School of Hygiene and Tropical Medicine Clinical Trials Unit, London, UK.
FAU - Nguyen, Hanna
AU  - Nguyen H
AD  - Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, 
      King's College London, St. Thomas' Hospital, London, UK.
FAU - Wilson, Karen
AU  - Wilson K
AD  - Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, 
      King's College London, St. Thomas' Hospital, London, UK.
FAU - Whitbread, Mark
AU  - Whitbread M
AD  - Medical Directorate, London Ambulance Service, London, UK.
FAU - Hughes, Johanna
AU  - Hughes J
AD  - Medical Directorate, London Ambulance Service, London, UK.
FAU - Fothergill, Rachael T
AU  - Fothergill RT
AD  - Warwick Clinical Trials Unit and Heart of England NHS Foundation Trust, Warwick 
      Medical School, University of Warwick, Coventry, UK; Medical Directorate, London 
      Ambulance Service, London, UK.
FAU - Nevett, Joanne
AU  - Nevett J
AD  - Medical Directorate, London Ambulance Service, London, UK.
FAU - Mosweu, Iris
AU  - Mosweu I
AD  - King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, 
      King's College London, UK.
FAU - McCrone, Paul
AU  - McCrone P
AD  - King's Health Economics, Institute of Psychiatry, Psychology & Neuroscience, 
      King's College London, UK.
FAU - Dalby, Miles
AU  - Dalby M
AD  - Department of Cardiology, Royal Brompton and Harefield NHS Foundation Trust, 
      Middlesex, UK.
FAU - Rakhit, Roby
AU  - Rakhit R
AD  - Department of Cardiology, Royal Free NHS Foundation Trust, London, UK.
FAU - MacCarthy, Philip
AU  - MacCarthy P
AD  - Department of Cardiology, King's College Hospital NHS Foundation Trust, London, 
      UK.
FAU - Perera, Divaka
AU  - Perera D
AD  - Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, 
      King's College London, St. Thomas' Hospital, London, UK.
FAU - Nolan, Jerry P
AU  - Nolan JP
AD  - School of Clinical Sciences, University of Bristol and Department of Anaesthesia, 
      Royal United Hospital, Bath, UK.
FAU - Redwood, Simon R
AU  - Redwood SR
AD  - Cardiovascular Division, The Rayne Institute BHF Centre of Research Excellence, 
      King's College London, St. Thomas' Hospital, London, UK.
LA  - eng
GR  - FS/14/11/30526/BHF_/British Heart Foundation/United Kingdom
GR  - FS/15/78/31678/BHF_/British Heart Foundation/United Kingdom
GR  - CS/16/3/32615/BHF_/British Heart Foundation/United Kingdom
GR  - FS/13/15/30026/BHF_/British Heart Foundation/United Kingdom
GR  - 10/57/67/DH_/Department of Health/United Kingdom
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
DEP - 20180806
PL  - United States
TA  - Am Heart J
JT  - American heart journal
JID - 0370465
SB  - IM
MH  - *Cardiac Care Facilities/economics
MH  - Cardiopulmonary Resuscitation
MH  - Cost-Benefit Analysis
MH  - Emergency Service, Hospital/economics
MH  - Humans
MH  - London
MH  - Myocardial Infarction/*mortality/*therapy
MH  - Out-of-Hospital Cardiac Arrest/*mortality/*therapy
MH  - *Patient Transfer
MH  - Survival Rate
MH  - Time-to-Treatment
MH  - Triage
EDAT- 2018/08/10 06:00
MHDA- 2019/06/27 06:00
CRDT- 2018/08/10 06:00
PHST- 2018/01/06 00:00 [received]
PHST- 2018/06/30 00:00 [accepted]
PHST- 2018/08/10 06:00 [pubmed]
PHST- 2019/06/27 06:00 [medline]
PHST- 2018/08/10 06:00 [entrez]
AID - S0002-8703(18)30218-7 [pii]
AID - 10.1016/j.ahj.2018.06.016 [doi]
PST - ppublish
SO  - Am Heart J. 2018 Oct;204:92-101. doi: 10.1016/j.ahj.2018.06.016. Epub 2018 Aug 6.