Acute cardiac care & resuscitation
One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST Elevation: An Individual Patient Data Meta-Analysis
Corrected 23 Oct 2026: Measure wording clarified; no values changed.
Authors' conclusion
In this IPDMA of 2 RCTs, there was no benefit of immediate coronary angiography compared with a delayed or selective strategy during 1-year follow-up in successfully resuscitated patients with OHCA without ST-segment elevations. No subgroup of patients was identified that showed a differential treatment effect.
Study context
- Population
- Patients with out-of-hospital cardiac arrest (OHCA) without ST-segment elevation2 randomized clinical trials (RCTs) (COACT, TOMAHAWK)
- Participants
- 1,031 patients
- Comparison
- Immediate vs delayed or selective coronary angiography
- Immediate angiographyn = 522
- Delayed or selective angiographyn = 509reference
- Outcome
- Survival
- Follow-up
- 1 year
Methodological details1-stage individual participant data meta-analysis (IPDMA), stratified by randomized trial
- 1-stage IPDMA
- Stratified by randomized trial
Pooled result
1-year survival
Hazard ratio
1.15
95% CI 0.96–1.37, event not clearly stated
Events by group
As reported in the abstract
Further pooled results
Treatment effect by subgroup (age, sex, arrest rhythm, witnessed arrest, time to BLS, time to ROSC, CAD, DM, hypertension)
- No treatment-by-subgroup interactions suggesting heterogeneity
- P = 0.26 to P = .91
- Interaction P ranged from P = .26 to P = .91
Original publication
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