Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation

This multicenter randomized trial evaluated the effect of immediate coronary angiography versus delayed/selective angiography in 554 patients with resuscitated out-of-hospital cardiac arrest of possible cardiac origin, without ST-segment elevation. Patients were assigned to either strategy and monitored for 30-day all-cause mortality and neurologic outcomes. The primary outcome—death at 30 days—occurred in 54% of the immediate-angiography group vs. 46% in the delayed group, with no statistically significant benefit (hazard ratio 1.28; P=0.06). The composite endpoint of death or severe neurologic deficit was higher in the immediate group. Rates of myocardial infarction, bleeding, stroke, and renal therapy were comparable between groups. The study concludes that immediate angiography does not offer a survival advantage over delayed/selective angiography in this population.

This multicenter randomized trial evaluated the effect of immediate coronary angiography versus delayed/selective angiography in 554 patients with resuscitated out-of-hospital cardiac arrest of possible cardiac origin, without ST-segment elevation. Patients were assigned to either strategy and monitored for 30-day all-cause mortality and neurologic outcomes. The primary outcome—death at 30 days—occurred in 54% of the immediate-angiography group vs. 46% in the delayed group, with no statistically significant benefit (hazard ratio 1.28; P=0.06). The composite endpoint of death or severe neurologic deficit was higher in the immediate group. Rates of myocardial infarction, bleeding, stroke, and renal therapy were comparable between groups. The study concludes that immediate angiography does not offer a survival advantage over delayed/selective angiography in this population.