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Coronary Angiography after Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation: A Systematic Review and Meta-analysis of Randomised Trials
Session:
Comunicações Orais - Sessão 06 - Intervenção coronária
Speaker:
Gonçalo Ferraz Costa
Congress:
CPC 2023
Topic:
H. Interventional Cardiology and Cardiovascular Surgery
Theme:
25. Interventional Cardiology
Subtheme:
25.2 Coronary Intervention
Session Type:
Comunicações Orais
FP Number:
---
Authors:
Gonçalo Ferraz Costa; Iolanda Santos; João Sousa; Sofia Beirão; Eric Monteiro; Joana Guimarães; Rogério Teixeira; Diogo Fernandes
Abstract
<p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Introduction</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: Out-of-hospital cardiac arrest (OHCA) has a poor prognosis. The timing and role of early coronary angiography (CAG) in OHCA patients without ST-segment elevation remains unclear.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Objectives</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: To compare an early CAG versus delayed CAG strategy in OHCA patients without ST elevation.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Methods</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: We systematically searched PubMed, Embase and Cochrane databases, in June 2022, for randomised controlled trials (RCTs) comparing early versus delayed early CAG. A random-effects meta-analysis was performed.</span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Results</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:red">: </span></span></span><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif"><span style="color:black">A total of eight RCTs were included, providing a total of 2,167 patients: 1,068 in an early strategy and 1,099 in a delayed strategy. In terms of outcomes assessed, our meta-analysis revealed a similar rate of all-cause mortality (pooled odds ratio [OR] 1.10 [0.93, 1.31], <em>P</em>=0.27, I<sup>2</sup>=0%), neurological status (pooled OR 0.94 [0.74, 1.21], <em>P</em>=0.65, I<sup>2</sup>=0%), need of renal replacement therapy (pooled OR 1.11 [0.74, 1.66], <em>P</em>=0.63, I<sup>2</sup>=0%) and major bleeding events (pooled OR 1.14 [0.80, 1.61], <em>P</em>=0.47, I<sup>2</sup>=0%).</span></span></span></span></span></p> <p style="text-align:justify"><span style="font-size:11pt"><span style="font-family:Calibri,sans-serif"><strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">Conclusions</span></span></strong><span style="font-size:12.0pt"><span style="font-family:"Times New Roman",serif">: According to our meta-analysis, in patients who experienced OHCA without ST elevation, early CAG is not associated with reduced mortality or an improved neurological status.</span></span></span></span></p>
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