In patients resuscitated following an out of hospital cardiac arrest (OHCA), coronary artery disease is reported in about 70% of cases (1). In these cases percutaneous coronary intervention (PCI) may save myocardium and prevent arrhythmias. The role of intervention in patients with ST elevation myocardial infarction (STEMI) is accepted, however there is no agreement on the approach to the patient without STEMI.
The Coronary Angiography after Cardiac Arrest Trial(COACT) tested the hypothesis, that in patients without evidence of a STEMI on ECG, post cardiac arrest resuscitation, that immediate coronary angiography would result in greater survival, when compared to delayed angiography.
The Study: The COACT Trial
Lemkes, J.J et al. Coronary Angiography after Cardiac Arrest without ST-Segment Elevation. NEJM April 11,2019, 380;15: pp 1397-1407.
