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Sooner was not better when using ECG to determine candidates for urgent coronary angiography after out-of-hospital cardiac arrest (OHCA), according to the PEACE study from Europe.
The earlier the ECG acquisition after return of spontaneous circulation (ROSC), the higher the false positive rate, as determined by the proportion of patients with ECG findings suggestive of ST-segment elevation MI (STEMI) who were subsequently found to have no significant obstructive coronary artery disease on angiography:
ECG time under 8 minutes: false positive rate 18.5%
ECG time 8-33 minutes: 7.2% false positives (OR 0.34, 95% CI 0.13-0.87)
ECG time over 33 minutes: 5.8% false positives (OR 0.27, 95% CI 0.15-0.47)