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CAG after OHCAAcute Cardiac CareOpen Access
Coronary angiography after out-of-hospital cardiac arrest without ST-elevation
Key result
Immediate coronary angiography shows no 30-day survival benefit over deferred angiography in OHCA without ST-elevation.
- n=2,173
Why the trial?
Individual trials of early angiography after cardiac arrest without ST-elevation have been inconclusive or underpowered for key subgroups. This analysis pooled the available randomised evidence to define whether any group benefits from an early invasive strategy.
Does immediate coronary angiography improve 30-day survival in patients after out-of-hospital cardiac arrest without ST-elevation compared to deferred angiography?
Population
2,173 OHCA patients without ST-elevation pooled from 5 randomised trials incl. DISCO
Comparison
Immediate vs deferred coronary angiography
Design
Individual patient data meta-analysis of 5 randomised trials
Follow-up
30 days
Authors
Discussion
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Implication
Supports deferred angiography after out-of-hospital cardiac arrest without ST-elevation; confirms no 30-day survival benefit across five randomized trials.
Key Points
- To determine whether immediate coronary angiography improves 30-day survival compared with deferred angiography in patients resuscitated after out-of-hospital cardiac arrest without ST-segment elevation.
- Individual patient data meta-analysis pooling five randomized controlled trials, including the DISCO trial (total N=2,173).
- Compared immediate versus deferred coronary angiography strategies.
- No statistically significant difference in 30-day survival was observed between immediate and deferred angiography groups (pooled hazard ratio not reported in the source).
Evidence details
Limitations & tradeoffs
Statistical certainty
No pooled effect estimate or per-arm survival rates were published in the record.
Subgroup caution
Whether any subgroup benefits from early angiography — a stated aim of the pooling — is not answered in the available record.
Structured PICO
Does immediate coronary angiography improve 30-day survival in patients after out-of-hospital cardiac arrest without ST-elevation compared to deferred angiography?
P
Population
2,173 patients with out-of-hospital cardiac arrest without ST-elevation pooled from five randomized trials.
I
Intervention
Immediate coronary angiography
C
Comparator
Deferred coronary angiography
O
Outcome
30-day survivalhard clinical
A pooled analysis of 5 RCTs confirms that immediate coronary angiography does not improve 30-day survival compared to deferred angiography in patients successfully resuscitated from out-of-hospital cardiac arrest without ST-elevation.
Cite This Study
Lente Pol (2026) conducted a meta-analysis in Out-of-hospital cardiac arrest without ST-elevation (n=2,173). Immediate coronary angiography vs. Deferred coronary angiography was evaluated on 30-day survival. Immediate coronary angiography showed no difference in 30-day survival compared to deferred angiography in patients after out-of-hospital cardiac arrest without ST-elevation.