Acute cardiac care & resuscitation
Immediate vs Delayed Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation: 5-Year Outcomes From the COACT Randomized Trial
Authors' conclusion
At 5 years, survival was comparable between immediate and delayed angiography, with no clear benefit or harm.
Study context
- Population
- Out-of-hospital cardiac arrest (OHCA) patients with initial shockable rhythm and no ST-segment elevation on initial ECG after return of spontaneous circulation514 analysed
- Participants
- 552 patients
- Comparison
- Immediate vs delayed coronary angiography
- Immediaten = 261
- Delayedn = 253reference
- Primary endpoint
- Survival
- Follow-up
- 5 years
Methodological detailsopen-label, multicentre, 19 Dutch centres
- Open-label
- Multicentre
- 19 Dutch centres
Primary result
Alive
Hazard ratio
0.95
95% CI 0.74–1.23
log-rank P = 072
Events by treatment group
Immediate vs Delayed
HR 0.95 (95% CI 0.74–1.23); log-rank P = 072
As reported in the abstract
Secondary outcomes
Death, landmark analysis (nonprespecified, exploratory)
- HR for death to 90 days
- 1.11 (95% CI: 0.84-1.49; log-rank P = 0.46)
- HR for death >90 days
- 0.56 (95% CI: 0.32-0.97; log-rank P = 0.04)
- Nonprespecified and exploratory landmark analysis
MI, HF-related hospitalization, revascularization
- Rates low and did not differ between groups
Original publication
Immediate vs Delayed Coronary Angiography After Cardiac Arrest Without ST-Segment Elevation: 5-Year Outcomes From the COACT Randomized Trial. J Am Coll Cardiol. Published 4 February 2026. doi:10.
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