Acute cardiac care & resuscitation
Expedited transfer to emergency department vs. cardiac catheter laboratory in a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest: ARREST trial as-treated analysis
Authors' conclusion
In this as-treated analysis of the ARREST trial, in adult patients with resuscitated OHCA without ST-elevation, we observed a lower 30-day mortality and favourable neurological outcomes following delivery to an ED in a CAC and cardiac catheter laboratory in CAC, when compared with delivery to ED in a non-CAC.
Study context
- Population
- Patients (aged ≥18 years) with resuscitated out-of-hospital cardiac arrest (OHCA) without ST elevation enrolled in the ARREST trial, delivered by London Ambulance Service to one of 35 hospitals in London, UKenrolled into the trial, primary outcome data available in 818/862 (94.9%)
- Participants
- 862 patients
- Comparison
- Delivery to an ED in a cardiac arrest centre (CAC) or cardiac catheter laboratory in a CAC vs delivery to ED in a non-CAC
- ED in a CACn = 182
- Cardiac catheter laboratory in a CACn = 403
- ED in a non-CACn = 233reference
- Primary endpoint
- All-cause mortality
- Follow-up
- 30 days
Methodological detailsadjusted for age, sex, initial shockable rhythm, witnessed cardiac arrest, bystander CPR, the time from cardiac arrest until ROSC, and location of cardiac arrest
- Adjusted for age, sex, initial shockable rhythm, witnessed cardiac arrest, bystander CPR, the time from cardiac arrest until ROSC, and location of cardiac arrest
Primary result
As reported in the abstract
Each group vs ED in a non-CACAdjusted odds ratio (95% CI)P value
ED in a CAC
0.43(0.24–0.76)
P = 0.0039Cardiac catheter laboratory in a CACno statistical difference
0.72(0.44–1.18)
P = 0.19Secondary outcomes
Survival with a favourable neurological outcome · hospital discharge
Original publication
Expedited transfer to emergency department vs. cardiac catheter laboratory in a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest: ARREST trial as-treated analysis. Eur Heart J Acute Cardiovasc Care. Published 22 October 2025. doi:10.
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