Methodology Score: 4.5/5
Usefulness Score: 3.5/5

Lemkes JS, et al. N Engl J Med. 2019 Apr 11;380(15):1397-1407.

Editorial: Coronary Angiography after Cardiac Arrest – The Right Timing or the Right Patients?

Question and Methods: Patients with out-of-hospital cardiac arrest (OHCA) and shockable rhythm, but without STEMI on ECG following ROSC were randomized 1:1 to either immediate angiography (within 2 hours) or delayed angiography.

Findings: Among 552 patients from 19 centres, survival at 90 days among patients with immediate angiography was not significantly different from patients with delayed angiography (64.5% vs. 67.2%, P=0.51).

Limitations: Minor limitations include the lack of blinding, and the relatively smaller proportion of patients with true unstable coronary lesions.

Interpretation: Among patients with ROSC following OHCA but without signs of STEMI on ECG, immediate angiography was not superior to delayed angiography in 90-day mortality.

By: Dr. Shannon Fernando

Hans Rosenberg
Dr. Rosenberg is an emergency physician at the Ottawa Hospital, assistant professor at the University of Ottawa, and Director of the Digital Scholarship and Knowledge Dissemination Program.