Can coronary CT in out-of-hospital cardiac arrest be used to screen those who are appropriate for invasive coronary angiography? A new paradigm? It's estimated that 10-15% of out-of-hospital circulatory arrest (OHCA) are due to a coronary artery disease (CAD). Prior studies suggested early invasive coronary angiography (ICA) ± coronary intervention improves outcomes in OHCA survivors. The COACT randomized trial showed similar outcomes to early versus delayed ICA in OHCA survivors. Urgent ICA may not be warranted in all survivors of OHCA.