TY - JOUR
T1 - Early coronary angiography in patients after out-of-hospital cardiac arrest without ST-segment elevation
T2 - Meta-analysis of randomized controlled trials
AU - Freund, Anne
AU - van Royen, Niels
AU - Kern, Karl B.
AU - Jobs, Alexander
AU - Thiele, Holger
AU - TOMAHAWK, PEARL, and COACT investigators
AU - Lemkes, Jorrit S.
AU - Desch, Steffen
N1 - Funding Information: Open Access funding enabled and organized by Projekt DEAL. Publisher Copyright: © 2022 The Authors. Catheterization and Cardiovascular Interventions published by Wiley Periodicals LLC.
PY - 2022/9/1
Y1 - 2022/9/1
N2 - Objectives: To compare early coronary angiography to a delayed or selective approach in out-of-hospital cardiac arrest (OHCA) without ST-segment elevation of possible cardiac cause by means of meta-analysis of available randomized controlled trials (RCTs). Methods: We searched MEDLINE and the Cochrane Central Register of Controlled Trials for RCTs comparing early with delayed or selective coronary angiography in OHCA patients of possible cardiac origin without ST-segment elevation. The primary endpoint was all-cause short-term mortality (PROSPERO CRD42021271484). Results: The search strategy identified three RCTs enrolling a total of 1167 patients. An early invasive approach was not associated with improved short-term mortality (odds ratio 1.19, 95% confidence interval 0.94–1.52; p = 0.15). Further, no significant differences were shown with respect to the risk of severe neurological deficit, the composite of all-cause mortality or severe neurological deficit, need for renal replacement therapy due to acute renal failure, and significant bleeding at short-term follow-up. Conclusion: Early coronary angiography in OHCA without ST-segment elevation is not superior compared to a delayed/selective approach.
AB - Objectives: To compare early coronary angiography to a delayed or selective approach in out-of-hospital cardiac arrest (OHCA) without ST-segment elevation of possible cardiac cause by means of meta-analysis of available randomized controlled trials (RCTs). Methods: We searched MEDLINE and the Cochrane Central Register of Controlled Trials for RCTs comparing early with delayed or selective coronary angiography in OHCA patients of possible cardiac origin without ST-segment elevation. The primary endpoint was all-cause short-term mortality (PROSPERO CRD42021271484). Results: The search strategy identified three RCTs enrolling a total of 1167 patients. An early invasive approach was not associated with improved short-term mortality (odds ratio 1.19, 95% confidence interval 0.94–1.52; p = 0.15). Further, no significant differences were shown with respect to the risk of severe neurological deficit, the composite of all-cause mortality or severe neurological deficit, need for renal replacement therapy due to acute renal failure, and significant bleeding at short-term follow-up. Conclusion: Early coronary angiography in OHCA without ST-segment elevation is not superior compared to a delayed/selective approach.
KW - coronary angiography
KW - out-of-hospital cardiac arrest
KW - survival
UR - http://www.scopus.com/inward/record.url?scp=85135155721&partnerID=8YFLogxK
U2 - https://doi.org/10.1002/ccd.30355
DO - https://doi.org/10.1002/ccd.30355
M3 - Article
C2 - 35900214
SN - 1522-1946
VL - 100
SP - 330
EP - 337
JO - Catheterization and cardiovascular interventions
JF - Catheterization and cardiovascular interventions
IS - 3
ER -