Acute cardiac care & resuscitation
Effect of timing of coronary angiography on mortality after out-of-hospital cardiac arrest in elderly patients: a substudy of the TOMAHAWK trial
Authors' conclusion
Routine immediate coronary angiography does not appear to modify mortality risk in both elderly and younger OHCA survivors without ST-segment elevations. The results do not support differential treatment strategies across age groups.
Study context
- Population
- Patients with successfully resuscitated out-of-hospital cardiac arrest (OHCA) of presumed cardiac origin without ST-segment elevations on post-resuscitation electrocardiogramspatients analysed
- Participants
- 529 patients
- Comparison
- Immediate vs. delayed/selective coronary angiography in elderly vs. younger OHCA survivors
- Primary endpoint
- 30-day mortality
- Follow-up
- 30 days
Methodological detailsMultivariable Cox regression models, stratified by age
- Multivariable Cox regression models
- Stratified by age
Primary result
As reported in the abstract
immediate vs delayed/selectiveHazard ratio (95% CI)P value
Elderly patients; timing of coronary angiography, adjusted; not significant; comparator group not stated in the abstract
0.96(0.59–1.56)
P = 0.88Younger patients; timing of coronary angiography, adjusted; not significant; comparator group not stated in the abstract
0.88(0.56–1.38)
P = 0.57Further findings
| Outcome | Elderly patients | Younger patients | P value |
|---|---|---|---|
| Death or severe neurologic deficitElderly patients vs younger patients · higher in elderly patients | 75% | 51% | P < 0.001 |
Cardiovascular comorbidities
- Elderly patients exhibited a greater burden of cardiovascular comorbidities
Original publication
Effect of timing of coronary angiography on mortality after out-of-hospital cardiac arrest in elderly patients: a substudy of the TOMAHAWK trial. Eur Heart J Acute Cardiovasc Care. Published 7 November 2025. doi:10.
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