Lemkes JS, et al. - In this investigation involving 552 patients, researchers investigated if immediate coronary angiography and percutaneous coronary intervention (PCI) has any benefit for patients who were resuscitated effectively following cardiac arrest without ST-segment elevation myocardial infarction (STEMI). The results obtained from this multicenter trial indicate that an immediate angiography strategy was not better than a delayed angiography strategy for 90-day overall survival among these patients.

Methods

• For this investigation, patients who had cardiac arrest without signs of STEMI were randomized to immediate coronary angiography or coronary angiography that was delayed until after neurologic recovery.
• Survival at 90 days was the primary end point.
• Survival at 90 days with good cerebral performance or mild or moderate disability, myocardial injury, duration of catecholamine support, markers of shock, recurrence of ventricular tachycardia, duration of mechanical ventilation, major bleeding, occurrence of acute kidney injury, need for renal-replacement therapy, time to target temperature, and neurologic status at discharge from the intensive care unit were included secondary end points.

Results

• There were 176 out of 273 subjects (64.5%) in the immediate angiography group and 178 out of 265 subjects (67.2%) in the delayed angiography group alive at 90 days (odds ratio, 0.89; 95% confidence interval [CI], 0.62 to 1.27; P=0.51).
• In the immediate angiography group, the median time to target temperature was 5.4 hours; in the delayed angiography group, it was 4.7 hours (ratio of geometric means, 1.19; 95% CI, 1.04 to 1.36).
• There were no significant differences in the remaining secondary endpoints between the groups.