Universität zu Köln

Heyne, Sebastian ORCID: 0000-0002-1581-9954, Macherey, Sascha, Meertens, Max M., Braumann, Simon, Niessen, Franz S., Tichelbaecker, Tobias, Baldus, Stephan, Adler, Christoph and Lee, Samuel ORCID: 0000-0001-6768-7079 (2023). Coronary angiography after cardiac arrest without ST-elevation myocardial infarction: a network meta-analysis. Eur. Heart J., 44 (12). S. 1040 - 1055. OXFORD: OXFORD UNIV PRESS. ISSN 1522-9645

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Abstract

Aims This network meta-analysis aimed to assess the effect of early coronary angiography (CAG) compared with selective CAG (late and no CAG) for patients after out-of-hospital cardiac arrest without ST-elevation myocardial infarction (NSTE-OHCA). Methods and results A systematic literature search was performed using the EMBASE, MEDLINE and Web of Science databases without restrictions on publication date. The last search was performed on 15 July 2022. Randomized controlled trials (RCTs) and non-randomized studies (NRS) comparing the effect of early CAG to selective CAG after NSTE-OHCA on survival and/or neurological outcomes were included. Meta-analyses were performed based on a DerSimonian-Laird random effects model. A total of 18 studies were identified by the literature search. After the exclusion of two studies due to high risk of bias, 16 studies (six RCTs, ten NRS) were included in the final analyses. Meta-analyses showed a statistically significant increase in survival after early CAG compared with selective CAG in the overall analysis [OR: 1.40, 95% confidence interval (CI): (1.12-1.76), P < 0.01, I-2 = 68%]. This effect was lost in the subgroup analysis of RCTs [OR: 0.89, 95% CI: (0.73-1.10), P = 0.29, I-2 = 0%]. Random effects model network meta-analysis of NRS based on a Bayesian method showed statistically significant increased survival after late compared with early CAG [OR: 4.20, 95% CI: (1.22, 20.91)]. Conclusion The previously reported superiority of early CAG after NSTE-OHCA is based on NRS at high risk of selection and survivorship bias. The meta-analysis of RCTs does not support routinely performing early CAG after NSTE-OHCA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Heyne, Sebastian UNSPECIFIED orcid.org/0000-0002-1581-9954 UNSPECIFIED Macherey, Sascha UNSPECIFIED UNSPECIFIED UNSPECIFIED Meertens, Max M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Braumann, Simon UNSPECIFIED UNSPECIFIED UNSPECIFIED Niessen, Franz S. UNSPECIFIED UNSPECIFIED UNSPECIFIED Tichelbaecker, Tobias UNSPECIFIED UNSPECIFIED UNSPECIFIED Baldus, Stephan UNSPECIFIED UNSPECIFIED UNSPECIFIED Adler, Christoph UNSPECIFIED UNSPECIFIED UNSPECIFIED Lee, Samuel UNSPECIFIED orcid.org/0000-0001-6768-7079 UNSPECIFIED
URN:	urn:nbn:de:hbz:38-659146
DOI:	10.1093/eurheartj/ehac611
Journal or Publication Title:	Eur. Heart J.
Volume:	44
Number:	12
Page Range:	S. 1040 - 1055
Date:	2023
Publisher:	OXFORD UNIV PRESS
Place of Publication:	OXFORD
ISSN:	1522-9645
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language AMERICAN-HEART-ASSOCIATION; 2015 ESC GUIDELINES; TASK-FORCE; SURVIVORS; OUTCOMES; IMPACT; RESUSCITATION; INTERVENTION; MANAGEMENT; STATEMENT Multiple languages Cardiac & Cardiovascular Systems Multiple languages
URI:	http://kups.ub.uni-koeln.de/id/eprint/65914