title: Cardiac catheterization is associated with superior outcomes for survivors of out of hospital cardiac arrest: review and meta-analysis.
abstract: OBJECTIVE
  Survivors of out-of-hospital cardiac arrest (OHCA) have a high rate of morbidity and mortality. Invasive cardiac assessment with coronary angiography offers the potential for improving outcomes by facilitating early revascularization. The aim of the present study was to review the published data on early coronary angiography for survivors of OHCA, and its impact on survival and neurological outcomes.
  
  
  METHODS
  Medline, Embase and PubMed were searched with a structured search query. The primary outcome was in-hospital (or if not available, 30 day or 6 month) survival. Rates of survival with good neurological outcome were a secondary endpoint. The time period of the search was from 1 January 1980 to 1 January 2014. Data was pooled with means and 95% CI interval calculated. Meta-analysis of the main outcomes was performed using a weighted random effects model.
  
  
  RESULTS
  Following review of all identified records, 105 relevant full text articles were retrieved. Fifty had adequate outcome information stratified by the use of coronary angiography for analysis. In studies where a control group was available for comparison, the overall survival in the acute angiography group was 58.8% versus 30.9% in the control group (Odds ratio 2.77, 95% CI 2.06-3.72). Survival with good neurological outcome (as per the Utstein framework) in the early angiography group was 58% versus 35.8% in the control group (Odds ratio 2.20, 95% CI 1.46-3.32).
  
  
  CONCLUSIONS
  Early coronary angiography in patients following OHCA is associated with improved outcome and better survival.
authors.affiliation: Mater Health Cardiovascular Unit, South Brisbane, QLD, Australia; Princess Alexandra Hospital, Department of Cardiology, Brisbane, QLD, Australia; University of Queensland, Brisbane, QLD, Australia. Electronic address: acamuglia@heartcarepartners.com.au.
authors.forename: Anthony C
authors.initials: AC
authors.lastname: Camuglia
authors.affiliation: London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
authors.forename: Varinder K
authors.initials: VK
authors.lastname: Randhawa
authors.affiliation: London Health Sciences Centre, University of Western Ontario, London, ON, Canada.
authors.forename: Shahar
authors.initials: S
authors.lastname: Lavi
authors.affiliation: University of Queensland, Brisbane, QLD, Australia; The Prince Charles Hospital, Chermside, Brisbane, QLD, Australia.
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000379:methods / Q000401:mortality; D006328:Cardiac Catheterization / Q000379:methods*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D017023:Coronary Angiography / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000000981:diagnostic imaging* / Q000401:mortality / Q000628:therapy*; D011379:Prognosis; D018570:Risk Assessment; D016019:Survival Analysis; D017741:Survivors / Q000706:statistics & numerical data; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac catheterization; Coronary angiography; Out-of-hospital cardiac arrest