The role of coronary angiography in out-of-hospital cardiac arrest patients in the absence of ST-segment elevation: A literature review

E. M. Spoormans, J. S. Lemkes*, G. N. Janssens, N. W. van der Hoeven, J. L. Bonnes, N. van Royen

*Corresponding author for this work

Research output: Contribution to journalReview articleAcademicpeer-review

Abstract

Out-of-hospital cardiac arrest (OHCA) is a major cause of death. Although the aetiology of cardiac arrest can be diverse, the most common cause is ischaemic heart disease. Coronary angiography and percutaneous coronary intervention, if indicated, has been associated with improved long-term survival for patients with initial shockable rhythm. However, in patients without ST-segment elevation on the post-resuscitation electrocardiogram, the optimal timing of performing this invasive procedure is uncertain. One important challenge that clinicians face is to appropriately select patients that will benefit from immediate coronary angiography, yet avoid unnecessary delay of intensive care support and targeted temperature management. Observational studies have reported contradictory results and until recently, randomised trials were lacking. The Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) was the first randomised trial that provided comparative information between coronary angiography treatment strategies. This literature review will provide the current knowledge and gaps in the literature regarding optimal care for patients successfully resuscitated from OHCA in the absence of ST-segment elevation and will primarily focus on the role and timing of coronary angiography in this high-risk patient population.

Original languageEnglish
Pages (from-to)108-114
Number of pages7
JournalNetherlands Heart Journal
Volume28
DOIs
Publication statusPublished - 1 Aug 2020

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