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Coronary angiography after cardiac arrest without ST segment elevation

JAMA Cardiology Dec 22, 2020

Lemkes JS, Janssens GN, van der Hoeven NW, et al. - By performing this prespecified analysis of a multicenter, open-label, randomized clinical trial, researchers investigated if immediate coronary angiography, vs a delayed coronary angiography strategy, improves clinical results at 1 year in patients following cardiac arrest without signs of ST segment elevation myocardial infarction (STEMI). Overall 552 patients enrolled in 19 Dutch centers between January 8, 2015, and July 17, 2018, were analyzed. The main outcomes included survival, myocardial infarction, revascularization, implantable cardiac defibrillator shock, quality of life, hospitalization for heart failure, and the composite of mortality or myocardial infarction or revascularization following 1 year. According to findings, a strategy of immediate angiography lacked superiority in terms of clinical results at 1 year when compared with a strategy of delayed angiography in patients successfully resuscitated following out-of-hospital cardiac arrest and without signs of STEMI. Thus, in this patient population, coronary angiography can be delayed until after neurologic recovery without impacting results.

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