Desch S, Freund A, Akin I, et al. - Immediate angiography in patients with resuscitated out-of-hospital cardiac arrest without ST-segment elevation did not offer any benefit over delayed or selective angiography with respect to the 30-day risk of death from any cause.

• This multicenter trial involved patients with successfully resuscitated out-of-hospital cardiac arrest of possible coronary origin and having no evidence of ST-segment elevation on postresuscitation electrocardiography.

• Patients were randomized (n=554) to receive either immediate coronary angiography (immediate-angiography group) or initial intensive care assessment with delayed or selective angiography (delayed-angiography group).

• Death, at 30 days, occurred in 54.0% in the immediate-angiography group and in 46.0% in the delayed-angiography group (hazard ratio, 1.28).

• In the immediate-angiography group, a more frequent occurrence of the composite of death or severe neurologic deficit was evident (64.3%) vs in delayed-angiography group (55.6%), for a relative risk of 1.16.

• Both groups had similar values for peak troponin release as well as for the incidence of moderate or severe bleeding, stroke, and renal-replacement therapy.