Acute cardiac care & resuscitationMeta-analysis
One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST Elevation
- Individual participant data meta-analysis of randomised trials
- 1-stage individual participant data meta-analysis (IPDMA)
- stratified by randomized trial
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 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
Pooled result
1-year survival
Hazard ratio
1.15
95% CI 0.96–1.37
Events by group
Immediate angiography vs Delayed or selective angiography
HR 1.15 (95% CI 0.96–1.37)
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
One-Year Outcomes of Coronary Angiography After Out-of-Hospital Cardiac Arrest Without ST Elevation. JAMA Cardiol. Published 1 August 2025. doi:10.1001/jamacardio.2025.1194
Summarised from the published abstract; every number is checked against it