12. Coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation: a systematic review and meta-analysis of randomised trials

Coronary angiography after out-of-hospital cardiac arrest without ST-segment elevation: a systematic review and meta-analysis of randomised trials

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Average read time: 30 to 40 minutes

Short Summary of the Article:

The article titled “Coronary Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation: A Systematic Review and Meta-analysis” examines the efficacy and safety of early versus delayed coronary angiography (CAG) in patients who experience out-of-hospital cardiac arrest (OHCA) but without ST-segment elevation on an electrocardiogram. The meta-analysis, based on seven randomized controlled trials (RCTs), found no significant difference in all-cause mortality, neurological status, renal replacement therapy, or major bleeding events between early and delayed CAG groups. The findings suggest that early CAG may not offer a mortality benefit in this specific patient population, leading the authors to call for further research to refine the timing of CAG in these patients.

Learning Outcomes 

Upon completion of this activity, you should have an understanding of:

1. The Role of Early CAG in OHCA Patients without ST-Segment Elevation: Understanding that early CAG may not reduce mortality or improve neurological outcomes compared to delayed CAG in patients without ST-segment elevation.
2. Clinical Decision Making for CAG Timing: Insights into how and when coronary angiography should be performed in OHCA patients, particularly when ST-segment elevation is absent.
3. Impact of CAG on Safety Outcomes: Recognizing that both early and delayed CAG present similar safety profiles concerning major bleeding events and the need for renal replacement therapy.