Acute cardiac care & resuscitationSecondary analysis
Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation
- Secondary analysis of the TOMAHAWK randomised trial
- multicentre
- international (Germany and Denmark)
- investigator-initiated
- open-label
Authors' conclusion
This study found that a strategy of immediate coronary angiography does not provide clinical benefit compared with a delayed or selective invasive approach for patients 1 year after resuscitated OHCA of presumed coronary cause and without ST-segment elevation.
Study context
- Population
- Resuscitated OHCA of presumed cardiac origin with stable return of spontaneous circulation, without ST-segment elevation on postresuscitation ECG
- Participants
- 554 participants
- Comparison
- Immediate vs delayed or selective coronary angiography
- Immediate angiographyn = 281
- Delayed or selectiven = 273reference
- Primary endpoint
- All-cause mortality
- Follow-up
- 1 year
Primary result
As reported in the abstract
Hazard ratio
1.25
95% CI 0.99–1.57
P = 0.05
Events by treatment group
Immediate angiography vs Delayed or selective
HR 1.25 (95% CI 0.99–1.57); P = 0.05
Further findings
Severe neurologic deficit, MI, rehospitalization for congestive HF (survivors at 1 year)
- Similar between the groups
Original publication
Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation. JAMA Cardiol. Published 1 September 2023. doi:10.1001/jamacardio.2023.2264
Summarised from the published abstract; every number is checked against it