Table 2.

Summary of key randomized controlled trials evaluating the role of coronary angiography in patients with out-of-hospital cardiac arrest without ST-segment elevation on electrocardiogram^a

Reference, year, study title	Clinical trial identifier, location	No. of patients	Definition of early CAG	Definition of nonearly CAG	Primary end point	Key results on the primary end point	Favors early angiography
Lemkes et al,16 2019 COACT	NTR4973, Netherlands	552	<2 h after randomization	After neurologic recovery	Survival at 90 d	OR, 0.89; 95% CI, 0.62-1.27; P = .51	No
Desch et al,45 2021 TOMAHAWK	NCT02750462, Germany	530	As soon as possible after hospital admission	>24 h after cardiac arrest or not at all	Death due to any cause at 30 d	HR, 1.28; 95% CI, 1.00-1.63; P = .06	No
Kern et al,46 2020 PEARL	NCT02387398, USA, Slovenia, and Australia	99	<120 min of admission	>6 h from admission or not at all	Safety and efficacy of early CAG	55.1% vs 46.0%; P = .64	No
Hauw-Berlemount et al,47 2022 EMERGE	NCT02876458, France	279	Transferred directly to the catheterization laboratory	Admitted to the intensive care unit, and CAG planned 48-96 h after admission	180-d survival rate, with no or minimal neurologic sequelae; CPC score of 1 or 2	HR, 0.87; 95% CI, 0.65-1.15; P = .324	No
COUPE	NCT02641626, Spain	166	As soon as possible after randomization	After extubation if the patient has a good neurologic prognosis	Composite of in-hospital survival and 6-mo survival free of severe dependence (CPC score of 1 or 2)	Yet to be published
DISCO	NCT02309151, Sweden	1006b	<120 min from randomization	Should preferably not be performed until 3 d after the cardiac arrest	30-d survival	Yet to be published
Lavi S, Cardiac Catheterization in Cardiac Arrest	NCT02587494, Canada	75b	Within 12 h of ROSC	After completion of mild therapeutic hypothermia or apyrexia for >24 h after ROSC	Composite of death and poor neurologic outcomes (CPC score of 1 or 2) at 30 d	Yet to be published
ARREST	NCT03872960, United Kingdom	804	To be treated same as ST-segment elevation after ROSC. Patient to be transferred to the cath lab.	Triage for cath lab to be delayed until at least 72 hours after arrest	30-d all cause mortality	Yet to be published

ARREST, A Randomised Trial of Expedited Transfer to a Cardiac Arrest Centre for Non-ST Elevation Out-of-hospital Cardiac Arrest; CAG, coronary angiography; CI, confidence interval; COACT, Coronary Angiography After Cardiac Arrest; COUPE, Coronariography in Out of Hospital Cardiac Arrest; CPC, cerebral performance category; DISCO, Direct or Subacute Coronary Angiography in Out-of-hospital Cardiac Arrest; EMERGE, Emergency vs Delayed Coronary Angiogram in Survivors of Out-of-Hospital Cardiac Arrest; HR, hazard ratio; OHCA, out-of-hospital cardiac arrest, OR, odds ratio; PEARL, Randomized Pilot Clinical Trial of Early Coronary Angiography vs No Early Coronary Angiography for Postcardiac Arrest Patients Without ST-Segment Elevation; ROSC, return of spontaneous circulation; TOMAHAWK, Immediate Unselected Coronary Angiography vs Delayed Triage in Survivors of Out-of-Hospital Cardiac Arrest Without ST-Segment Elevation.

^aRandomized controlled trials evaluating the role of early versus nonearly coronary angiography in patients with out-of-hospital cardiac arrest without ST-segment elevation on an electrocardiogram performed after return of spontaneous circulation.

^bEstimated enrollment.