Journal article
Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation A Systematic Review and Meta-Analysis
JACC. Cardiovascular interventions, Vol.13(19), pp.2193-2205
10/12/2020
DOI: 10.1016/j.jcin.2020.07.018
PMID: 33032706
Abstract
OBJECTIVES The authors conducted a meta-analysis to study clinical outcomes in patients who underwent early versus nonearly coronary angiography (CAG) in the setting of out-of-hospital cardiac arrest (OHCA) without ST-segment elevation.
BACKGROUND The benefit of performing early CAG in patients with OHCA without STE remains disputed.
METHODS MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials were searched according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines from inception until February 21, 2020. Early and nonearly CAG patients were identified on the basis of the definitions mentioned in respective published studies. The primary outcome studied was 30-day mortality. Secondary outcomes were neurological status and the rate of percutaneous coronary intervention (PCI) following cardiac arrest.
RESULTS Of 4,516 references, 11 studies enrolling 3,581 patients were included in the final meta-analysis. Random-effects analysis showed no differences in 30-day mortality (risk ratio [RR]: 0.86; 95% confidence interval [CI]: 0.71 to 1.04; p = 0.12; I-2 = 74%), neurological status (RR: 1.08; 95% CI: 0.94 to 1.24; p = 0.28; I-2 = 69%), and rate of PCI (RR: 1.22; 95% CI: 0.94 to 1.59; p = 0.13; I-2 = 67%) between the 2 groups. Diabetes mellitus, chronic renal failure, previous PCI, and lactate level were found to be significant predictors of 30-day mortality on meta-regression (p < 0.05).
CONCLUSIONS This analysis shows that there is no significant difference in 30-day mortality, neurological status, or rate of PCI among patients with OHCA without STE treated with early versus nonearly CAG. Thirty-day mortality is determined by presentation comorbidities rather than revascularization. (C) 2020 by the American College of Cardiology Foundation.
Details
- Title: Subtitle
- Coronary Angiography in Patients With Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation A Systematic Review and Meta-Analysis
- Creators
- Beni R. Verma - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAVikram Sharma - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAShashank Shekhar - Cleveland ClinicManpreet Kaur - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAShameer Khubber - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAAgam Bansal - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAJarmanjeet Singh - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAKeerat Rai Ahuja - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USASalik Nazir - University of ToledoMichael Chetrit - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAVenu Menon - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USAGrant Reed - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USASamir Kapadia - Cleveland Clin, Dept Cardiol, Heart & Vasc Inst, Cleveland, OH 44106 USA
- Resource Type
- Journal article
- Publication Details
- JACC. Cardiovascular interventions, Vol.13(19), pp.2193-2205
- DOI
- 10.1016/j.jcin.2020.07.018
- PMID
- 33032706
- NLM abbreviation
- JACC Cardiovasc Interv
- ISSN
- 1936-8798
- eISSN
- 1876-7605
- Publisher
- Elsevier
- Number of pages
- 13
- Language
- English
- Date published
- 10/12/2020
- Academic Unit
- Internal Medicine
- Record Identifier
- 9984806508702771
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