Immediate coronary angiography fails to boost survival after cardiac arrest, trial finds
Immediate coronary angiography did not improve 30-day survival compared with a deferred strategy in patients without ST-segment elevation on an ECG after out-of-hospital cardiac arrest. These were the main findings of the DISCO trial and a meta-analysis presented in a Hot Line session today at ESC Congress 2026.
A recent trial known as DISCO and a subsequent meta-analysis have concluded that immediate coronary angiography does not improve the 30-day survival rate for patients experiencing out-of-hospital cardiac arrest (OHCA) who lack ST-segment elevation on an electrocardiogram (ECG). The DISCO trial, conducted in Sweden, Denmark, and the Netherlands, involved 1,006 adult patients who were immobilized and had no ST-segment elevation on their ECGs.
Both immediate and deferred strategies for coronary angiography showed no significant difference in the primary endpoint of 30-day survival, which was 54.6% in the immediate group and 53.6% in the deferred group. Professor Sten Rubertsson from Uppsala University, who led the DISCO trial, stated that the results of this large randomized trial conclusively indicate that immediate coronary angiography does not enhance outcomes compared to a deferred strategy.
An individual-patient data meta-analysis led by Professor Niels van Royen from Radboud University Medical Centre in the Netherlands, which involved five trials, also found no correlation between immediate coronary angiography and improved 30-day survival or neurological outcomes. The researchers conclude that it is safe to postpone coronary angiography in patients with OHCA who lack ST-segment elevation on their ECGs.
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