Trial reportLancet (London, England)2023
Expedited transfer to a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest (ARREST): a UK prospective, multicentre, parallel, randomised clinical trial.
Trial report in Lancet (London, England), 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03872960 (A Randomised Trial of Expedited Transfer to a Cardiac Arrest Centre for Non-ST Elevation Out-of-hospital Cardiac Arrest), which is not on this map. Cited by 32 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
A Randomised Trial of Expedited Transfer to a Cardiac Arrest Centre for Non-ST Elevation Out-of-hospital Cardiac Arrest
Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it, 80 citations in OpenAlex.
- 2025 Korean Guidelines for Cardiopulmonary Resuscitation: Part 1. The update process and highlights.Clinical and experimental emergency medicine · 2026Guideline
- European Resuscitation Council and European Society of Intensive Care Medicine guidelines 2025: post-resuscitation care.Intensive care medicine · 2025Guideline
- Part 4: Systems of Care: 2025 American Heart Association Guidelines for Cardiopulmonary Resuscitation and Emergency Cardiovascular Care.Circulation · 2025Guideline
- Expedited transfer to emergency department vs. cardiac catheter laboratory in a cardiac arrest centre for non-ST-elevation out-of-hospital cardiac arrest: ARREST trial as-treated analysis.European heart journal. Acute cardiovascular care · 2026Trial
- Advanced resuscitative interventions in refractory out-of-hospital cardiac arrest: a retrospective cohort study of a physician-led pre-hospital team.Resuscitation plus · 2026Article
- Young ERC Resuscitation Science Masterclass Journal Club article: the ARREST trial.Resuscitation plus · 2026Article
- Design and rationale of the SPARC trial: a phase II, single-system randomized controlled trial of immediate transfer to specialty post-arrest care.Resuscitation plus · 2026Article
- Point-of-care testing for pre-hospital stratification after out-of-hospital cardiac arrest: the RAPID-MIRACLE study.European heart journal. Acute cardiovascular care · 2026Observational
- Centralization of post-resuscitation care after out-of-hospital cardiac arrest at cardiac arrest centres: a Danish nationwide follow-up study.Critical care (London, England) · 2026Article
- Impact of Violations of the Shortest Distance-Based Transport Protocol for Intra-Arrest on Clinical Outcomes in a Metropolitan City: A Large-Scale Registry Study.Journal of clinical medicine · 2026Article
- [Post-Resuscitation care in the intensive care unit].Medizinische Klinik, Intensivmedizin und Notfallmedizin · 2026Review
- Defining a Cardiogenic Shock Center and Its Relationship to Outcomes Among Patients With Cardiogenic Shock - A Scoping Review.Circulation reports · 2026Review
- Expedited transfer pathways vs. standard care for adults with out-of-hospital cardiac arrest: a systematic review and meta-analysis of randomized trials.Frontiers in medicine · 2026Review
- The Latest in Resuscitation Research: Highlights From the 2024 American Heart Association's Resuscitation Science Symposium.Journal of the American Heart Association · 2025Article
- Expert consensus statement on the evaluation, treatment, and transfer of cardiogenic shock using a Delphi method approach: a report of the Japan Critical Care Cardiology Committee (J4 CS).Journal of intensive care · 2025Article
- Effect of Cardiac Arrest Center Protocol Implementation on Survival After Nontraumatic Out-of-Hospital Cardiac Arrest.Journal of the American Heart Association · 2025Article
- The Time Is Ripe for Cardiac Arrest Centers and Regionalized Cardiac Arrest Networks: Insights From the Cardiac Arrest Survival Score.Journal of the American Heart Association · 2025Article
- Higher versus lower mean arterial blood pressure after cardiac arrest and resuscitation (MAP-CARE): A protocol for a randomized clinical trial.Acta anaesthesiologica Scandinavica · 2025Article
- CT imaging in post-resuscitation care of non-traumatic resuscitation room patients in German hospitals.BMC emergency medicine · 2025Article
- Right atrium area is associated with survival after out-of-hospital cardiac arrest: a single-center cohort study.Echo research and practice · 2025Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
20 authors at 14 institutions in 1 country.
Funding
Abstract
backgroundThe International Liaison Committee on Resuscitation has called for a randomised trial of delivery to a cardiac arrest centre. We aimed to assess whether expedited delivery to a cardiac arrest centre compared with current standard of care following resuscitated cardiac arrest reduces deaths.
methodsARREST is a prospective, parallel, multicentre, open-label, randomised superiority trial. Patients (aged ≥18 years) with return of spontaneous circulation following out-of-hospital cardiac arrest without ST elevation were randomly assigned (1:1) at the scene of their cardiac arrest by London Ambulance Service staff using a secure online randomisation system to expedited delivery to the cardiac catheter laboratory at one of seven cardiac arrest centres or standard of care with delivery to the geographically closest emergency department at one of 32 hospitals in London, UK. Masking of the ambulance staff who delivered the interventions and those reporting treatment outcomes in hospital was not possible. The primary outcome was all-cause mortality at 30 days, analysed in the intention-to-treat (ITT) population excluding those with unknown mortality status. Safety outcomes were analysed in the ITT population. The trial was prospectively registered with the International Standard Randomised Controlled Trials Registry, 96585404.
findingsBetween Jan 15, 2018, and Dec 1, 2022, 862 patients were enrolled, of whom 431 (50%) were randomly assigned to a cardiac arrest centre and 431 (50%) to standard care. 20 participants withdrew from the cardiac arrest centre group and 19 from the standard care group, due to lack of consent or unknown mortality status, leaving 411 participants in the cardiac arrest centre group and 412 in the standard care group for the primary analysis. Of 822 participants for whom data were available, 560 (68%) were male and 262 (32%) were female. The primary endpoint of 30-day mortality occurred in 258 (63%) of 411 participants in the cardiac arrest centre group and in 258 (63%) of 412 in the standard care group (unadjusted risk ratio for survival 1·00, 95% CI 0·90-1·11; p=0·96). Eight (2%) of 414 patients in the cardiac arrest centre group and three (1%) of 413 in the standard care group had serious adverse events, none of which were deemed related to the trial intervention.
interpretationIn adult patients without ST elevation, transfer to a cardiac arrest centre following resuscitated cardiac arrest in the community did not reduce deaths.
fundingBritish Heart Foundation.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.