Emergency Medicine

ACCESS Trial

ACCESS (Access to the Cardiac Catheterization Laboratory in Patients Without ST-Segment Elevation Myocardial Infarction Resuscitated from Out-of-Hospital Ventricular Fibrillation Cardiac Arrest) has been completed in Milwaukee County.

About the Research
The purpose of the ACCESS trial was to determine which of two standard treatments, if any, results in better outcome: (1) Initial cardiac catheterization laboratory (CCL) admission, or (2) initial intensive care unit (ICU) admission in adults 18-80 years of age successfully resuscitated from out-of-hospital cardiac arrest and no signs of a heart attack on tracings of the heartbeat.

This study was performed at 26 research sites throughout the United States and Canada. Medical College of Wisconsin and Froedtert Hospital was one of the sites that performed this research and entered 8 patients. Patients were included in the study following informed consent with the patient, their next-of-kin, or using exception from informed consent under emergency circumstances if the patient was unable to speak and next-of-kin could not be found. A total of 65 patients were entered into the ACCESS trial between January, 2018 and July, 2019; 68% were male with an average age of 64 years. Of the 65 patients, 75% were Caucasian, 15% were African-American, 8% were of unknown race, 1.6% were Native American, 1.6% were Asian, 3% of patients were Hispanic, and 23% were of unknown ethnicity. 

Study Results
The ACCESS trial was stopped early, in July, 2019, because the rate of subject enrollment was too low. The study results showed no difference in patient outcomes between treatment with initial CCL admission compared to initial ICU admission, including survival and functionally favorable survival at hospital discharge and 3 months following hospital discharge.

For additional information, please contact Tom Aufderheide, MD at (414) 805-6493 or via email at RRC@mcw.edu.