The ARREST Trial (2023) was a multicenter, open-label, randomized controlled study that assessed whether expedited transfer of resuscitated out-of-hospital cardiac arrest (OHCA) patients without ST-elevation to a cardiac arrest center (CAC) improved outcomes compared with transfer to the nearest emergency department (ED). A total of 862 adults (≥18 years) with return of spontaneous circulation (ROSC) following OHCA were randomized equally between the two strategies. Patients with non-cardiac causes of arrest, post-ROSC ST-elevation MI, pregnancy, or DNAR orders were excluded. The primary outcome, 30-day all-cause mortality, was identical between groups (63% vs. 63%; RR 1.00; 95% CI 0.90–1.11; P = NS). Secondary outcomes—including 3-month mortality (65% vs. 64%) and favorable modified Rankin score at 3 months (30% vs. 31%)—also showed no significant difference. The trial concluded that expedited transfer to a cardiac arrest center did not improve survival or neurologic outcomes compared with standard transfer in patients with non-ST-elevation OHCA.
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