Cardiac

Test the hypothesis that, in patients successfully resuscitated after cardiac arrest without ST-segment elevation, a strategy of immediate coronary angiography and PCI if necessary, results in better survival compared to a strategy of delayed
angiography.

This prespecified sub-study evaluated 552 patients,
successfully resuscitated from out-of-hospital cardiac
arrest without signs of STEMI.

Patients were randomized to either undergo immediate
coronary angiography or delayed coronary angiography, after neurologic recovery. All patients underwent PCI if indicated. The main outcomes of this analysis were left ventricular ejection fraction and end-diastolic and systolic volumes assessed by cardiac magnetic resonance imaging or echocardiography.

The mean (± standard deviation) left ventricular ejection fraction was 45.2% (±12.8) in the immediate angiography group and 48.4% (±13.2) in the delayed angiography group (mean difference: −3.19; 95% confidence interval , −6.75 to 0.37). Median left ventricular end-diastolic volume was 177 ml in the immediate angiography group compared to 169 ml in
the delayed angiography group (ratio of geometric means: 1.06; 95% CI, 0.95–1.19). In addition, mean left ventricular end-systolic volume was 90 ml in the immediate angiography group compared to 78 ml in the delayed angiography group.

Immediate coronary angiography was not found to improve left ventricular dimensions or function compared with a delayed angiography strategy.