• Meng-Chang Yang, Wu Meng-Jun, Xu Xiao-Yan, Kevin L Peng, Yong G Peng, and Ru-Rong Wang.
• Department of Anesthesiology, West China Hospital, Sichuan University.
• Medicine (Baltimore). 2020 Oct 9; 99 (41): e22197.

ObjectiveThis meta-analysis aimed to review the available evidence and evaluate the necessity of immediate coronary angiography (CAG) to obtain positive outcomes for out-of-hospital cardiac arrest (OHCA) patients without ST segment elevation.Data SourcesWeb of Science, PubMed, Embase, Chinese National Knowledge Infrastructure, Wanfang, and SinoMed databases.Study SelectionWe included observational and case-control studies of outcomes among individuals without ST segment elevation experiencing OHCA who had immediate, delayed, or no CAG.Data ExtractionWe extracted study details, as well as patient characteristics and outcomes.Data SynthesisSix studies (n = 2665) investigating mortality until discharge demonstrated a significant increase in survival benefit with early CAG (odds ratio [OR] = 1.78; 95%CI = 1.51-2.11; I = 81%; P < .0001). Seven studies (n = 2909) showed a significant preservation of neurological functions with early CAG at discharge (OR = 1.66; 95%CI = 1.37-2.02; P < .00001). Four studies (n = 1357) investigating survival outcomes with middle-term follow-up revealed no significant benefit with early CAG (OR = 1.21; 95%CI = 0.93-1.57; I = 66%; P = .15).ConclusionsOur meta-analysis demonstrates that there may be significant benefits in performing immediate CAG on patients who experience OHCA without ST segment elevation.

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