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The benefit of immediate coronary angiography and percutaneous coronary intervention (PCI) after cardiac arrest in the absence of ST-segment–elevation myocardial infarction (STEMI) is not known. In the Coronary Angiography after Cardiac Arrest (COACT) trial, investigators from the Netherlands randomized 552 such patients to either immediate or delayed (after neurologic recovery) coronary angiography — and, for both, PCI if indicated. The primary endpoint was 90-day survival (NTR4973).
The average age of the participants was 65, about 80% were men, a third had prior known coronary artery disease, and about two thirds had signs of ischemia on the electrocardiogram. The arrest was witnessed in about three quarters of participants; median time t…