Post-resuscitation myocardial dysfunction in out-of-hospital cardiac arrest patients randomized to immediate coronary angiography versus standard of care
Why the study?
Immediate coronary angiography may reduce post-resuscitation myocardial dysfunction after OHCA, but its effect in patients without ST-elevation was unclear.
Does immediate coronary angiography improve post-resuscitation myocardial function and cardiac biomarkers in patients with bystander-witnessed OHCA without ST-elevation?
Design
Secondary analysis of a randomized controlled trial
Follow-up
72 h
Authors
Discussion
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Member takes
Implication
Immediate angiography confers no myocardial recovery benefit in non-STE OHCA; reinforces delayed/selective strategy in primary trials.
Structured PICO
Does immediate coronary angiography improve post-resuscitation myocardial function and cardiac biomarkers in patients with bystander-witnessed OHCA without ST-elevation?
P
Population
78 patients with bystander-witnessed out-of-hospital cardiac arrest (OHCA) without ST-elevations on the ECG
I
Intervention
Immediate coronary angiography within two hours of cardiac arrest, with potential percutaneous coronary intervention (PCI)
C
Comparator
Standard-of-care with deferred angiography
O
Outcome
Left ventricle ejection fraction (LVEF) at 24 h, peak Troponin T levels, lactate clearance and NT-proBNP at 72 hsurrogate
Immediate coronary angiography does not improve early myocardial function or biomarker profiles in OHCA patients without ST-elevation compared to standard of care.
Cite This Study
Elfwén et al. (2020) studied this question.