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

Author

  • 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.