The COACT Trial (1) found no significant benefit at 90 days, between early versus late angiography, in OHCA in patients who had a shockable rhythm, who were resuscitated and had no ST elevation on their ECG. Cradiac arrest with shockable rhythms, account for approximately 60% of cardiac arrests.
In the TOMAHAWK trial, discussed here, they looked at potential superiority of immediate versus deferred coronary angiography (possibly followed by revascularization)on 30-day all-cause mortality in resuscitated patients with OHCA without ST-elevation. This was aimed to answer the question on non-shckable rhythms that the COACT Trial did’t address.
The Study
Desch S., et al. Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation. NEJM. Dec 2021. 385;27: 2544-2553.
