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.