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General Critical Care

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In a recent trial published at the Revista Española de Cardiología (English Edition), the researchers aimed to determine whether emergency coronary angiography (CAG) and percutaneous coronary intervention (PCI) following out-of-hospital cardiac arrest (OHCA) in patients without ST-segment elevation myocardial infarction (STEMI) would improve survival with good neurological outcome. In this open-label, randomized trial, 69 OHCA survivors without STEMI were randomly assigned to undergo immediate CAG or deferred CAG. The primary efficacy endpoint was in-hospital survival without severe dependence. The results showed no significant difference in the primary endpoint between the two groups, with in-hospital survival being 62.5% in the immediate CAG group and 58.8% in the delayed CAG group.


There were some differences in secondary endpoints, such as the incidence of acute kidney failure, which was more frequent in the immediate CAG group and infections, which were higher in the delayed CAG group. However, these differences were not enough to indicate any significant benefit of immediate CAG compared to deferred CAG.


In conclusion, the results of this trial show that in patients resuscitated after OHCA without STEMI, immediate CAG provided no benefit in terms of survival without neurological impairment compared to delayed CAG. Further research with larger sample sizes is needed to more definitively determine the role of emergency CAG and PCI following OHCA without STEMI.


https://www.sciencedirect.com/science/article/abs/pii/S1885585722001220?via%3Dihub

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