Early coronary angiography was not associated with reduced all-cause mortality compared to delayed angiography in patients with OHCA without ST elevation (OR 1.22; 95% CI 0.99-1.50; P=0.06).
Meta-Analysis (n=1,625)
Does early coronary angiography reduce mortality or improve neurological status in patients with out-of-hospital cardiac arrest without ST-segment elevation?
Early coronary angiography does not improve survival or neurological outcomes compared to a delayed strategy in patients with out-of-hospital cardiac arrest without ST-segment elevation.
Effect estimate: OR 1.22 (95% CI 0.99-1.50)
p-value: p=0.06
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. The optimal timing and role of early coronary angiography (CAG) in OHCA patients without ST-segment elevation remains unclear. The goal of this study is to compare an early CAG versus delayed CAG strategy in OHCA patients without ST elevation. METHODS: We systematically searched PubMed, Embase and Cochrane databases, in June 2022, for randomised controlled trials (RCTs) comparing early versus delayed early CAG. A random effects meta-analysis was performed. RESULTS: A total of seven RCTs were included, providing a total of 1625 patients: 816 in an early strategy and 807 in a delayed strategy. In terms of outcomes assessed, our meta-analysis revealed a similar rate of all-cause mortality (pooled odds ratio OR 1.22 0.99-1.50, P = 0.06, I 2 = 0%), neurological status (pooled OR 0.94 0.74-1.21, = 0.65, I 2 = 0%), need of renal replacement therapy (pooled OR 1.11 0.78-1.74, P = 0.47, I 2 = 0%) and major bleeding events (pooled OR 1.51 0.95-2.40, P = 0.08, I 2 = 69%). CONCLUSION: According to our meta-analysis, in patients who experienced OHCA without ST elevation, early CAG is not associated with reduced mortality or an improved neurological status.
Costa et al. (Wed,) conducted a meta-analysis in Out-of-hospital cardiac arrest without ST-segment elevation (n=1,625). Early coronary angiography vs. Delayed coronary angiography was evaluated on All-cause mortality (OR 1.22, 95% CI 0.99-1.50, p=0.06). Early coronary angiography was not associated with reduced all-cause mortality compared to delayed angiography in patients with OHCA without ST elevation (OR 1.22; 95% CI 0.99-1.50; P=0.06).