Objectives: To compare early coronary angiography to a delayed or selective
approach in out‐of‐hospital cardiac arrest (OHCA) without ST‐segment elevation of
possible cardiac cause by means of meta‐analysis of available randomized controlled
trials (RCTs).
Methods: We searched MEDLINE and the Cochrane Central Register of Controlled
Trials for RCTs comparing early with delayed or selective coronary angiography in
OHCA patients of possible cardiac origin without ST‐segment elevation. The primary
endpoint was all‐cause short‐term mortality (PROSPERO CRD42021271484).
Results: The search strategy identified three RCTs enrolling a total of 1167 patients. An
early invasive approach was not associated with improved short‐term mortality (odds
ratio 1.19, 95% confidence interval 0.94–1.52; p = 0.15). Further, no significant
differences were shown with respect to the risk of severe neurological deficit, the
composite of all‐cause mortality or severe neurological deficit, need for renal replacement
therapy due to acute renal failure, and significant bleeding at short‐term follow‐up.
Conclusion: Early coronary angiography in OHCA without ST‐segment elevation is
not superior compared to a delayed/selective approach.
| Identifer | oai:union.ndltd.org:DRESDEN/oai:qucosa:de:qucosa:88848 |
| Date | 04 January 2024 |
| Creators | Freund, Anne, van Royen, Niels, Kern, Karl B., Jobs, Alexander, Thiele, Holger, Lemkes, Jorrit S., Desch, Steffen |
| Publisher | Wiley |
| Source Sets | Hochschulschriftenserver (HSSS) der SLUB Dresden |
| Language | English |
| Detected Language | English |
| Type | info:eu-repo/semantics/publishedVersion, doc-type:article, info:eu-repo/semantics/article, doc-type:Text |
| Rights | info:eu-repo/semantics/openAccess |
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