{"id":21052,"date":"2022-02-07T05:09:00","date_gmt":"2022-02-06T21:09:00","guid":{"rendered":"http:\/\/csccm.org.cn\/?p=21052"},"modified":"2022-02-07T05:33:48","modified_gmt":"2022-02-06T21:33:48","slug":"nejm%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e4%b8%8d%e4%bc%b4st%e6%ae%b5%e6%8a%ac%e9%ab%98%e7%9a%84%e9%99%a2%e5%a4%96%e5%bf%83%e8%b7%b3%e9%aa%a4%e5%81%9c%e6%82%a3%e8%80%85%e7%9a%84%e8%a1%80","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=21052","title":{"rendered":"[NEJM\u53d1\u8868\u8bba\u6587]\uff1a\u4e0d\u4f34ST\u6bb5\u62ac\u9ad8\u7684\u9662\u5916\u5fc3\u8df3\u9aa4\u505c\u60a3\u8005\u7684\u8840\u7ba1\u9020\u5f71"},"content":{"rendered":"\n

ORIGINAL ARTICLE<\/a><\/p>\n\n\n\n

Angiography after Out-of-Hospital Cardiac Arrest without ST-Segment Elevation<\/h1>\n\n\n\n

Steffen Desch, Anne Freund, Ibrahim Akin,\u00a0et al<\/h3>\n\n\n\n

N Engl J Med 2021; 385:2544-2553
DOI: 10.1056\/NEJMoa2101909<\/h3>\n\n\n\n

Abstract<\/h2>\n\n\n\n

BACKGROUND<\/h2>\n\n\n\n

Myocardial infarction is a frequent cause of out-of-hospital cardiac arrest. However, the benefits of early coronary angiography and revascularization in resuscitated patients without electrocardiographic evidence of ST-segment elevation are unclear.<\/p>\n\n\n\n

METHODS<\/h2>\n\n\n\n

In this multicenter trial, we randomly assigned 554 patients with successfully resuscitated out-of-hospital cardiac arrest of possible coronary origin to undergo either immediate coronary angiography (immediate-angiography group) or initial intensive care assessment with delayed or selective angiography (delayed-angiography group). All the patients had no evidence of ST-segment elevation on postresuscitation electrocardiography. The primary end point was death from any cause at 30 days. Secondary end points included a composite of death from any cause or severe neurologic deficit at 30 days.<\/a><\/p>\n\n\n\n

RESULTS<\/h2>\n\n\n\n

A total of 530 of 554 patients (95.7%) were included in the primary analysis. At 30 days, 143 of 265 patients (54.0%) in the immediate-angiography group and 122 of 265 patients (46.0%) in the delayed-angiography group had died (hazard ratio, 1.28; 95% confidence interval [CI], 1.00 to 1.63; P=0.06). The composite of death or severe neurologic deficit occurred more frequently in the immediate-angiography group (in 164 of 255 patients [64.3%]) than in the delayed-angiography group (in 138 of 248 patients [55.6%]), for a relative risk of 1.16 (95% CI, 1.00 to 1.34). Values for peak troponin release and for the incidence of moderate or severe bleeding, stroke, and renal-replacement therapy were similar in the two groups.<\/p>\n\n\n\n

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CONCLUSIONS<\/h2>\n\n\n\n

Among patients with resuscitated out-of-hospital cardiac arrest without ST-segment elevation, a strategy of performing immediate angiography provided no benefit over a delayed or selective strategy with respect to the 30-day risk of death from any cause. (Funded by the German Center for Cardiovascular Research; TOMAHAWK ClinicalTrials.gov number, NCT02750462. opens in new tab<\/a>.)<\/p>\n","protected":false},"excerpt":{"rendered":"

ORIGINAL ARTICLE Angiography after Out-of-Hospital Card […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21052"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=21052"}],"version-history":[{"count":1,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21052\/revisions"}],"predecessor-version":[{"id":21053,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/21052\/revisions\/21053"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=21052"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=21052"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=21052"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}