Journal article
Coronary angiography and percutaneous coronary intervention in cardiac arrest patients without return of spontaneous circulation
Resuscitation, Vol.175, pp.133-141
06/01/2022
DOI: 10.1016/j.resuscitation.2022.03.027
PMID: 35367316
Abstract
Objectives: This study aimed to examine coronary angiography (CAG) findings, percutaneous coronary intervention (PCI) results and outcomes in out-of-hospital cardiac arrest patients (OHCA) without return of spontaneous circulation (ROSC) on admission to hospital.
Methods: We analyzed the OHCA register and compared CAG, PCI, and outcome data in patients with and without ROSC on admission to hospital.
Results: Between January 2012 and December 2020, 697 OHCA patients were analyzed. Of these, 163 (23%) did not have ROSC at admission. Patients without ROSC were younger (59 vs. 61 years, p = 0.001) and had a longer resuscitation time (62 vs. 18 minutes, p < 0.001) than patients with ROSC. Significant coronary artery disease was highly prevalent in both groups (65% vs. 68%, p = 0.48). Patients without ROSC had higher rates of acute coronary occlusions (42% vs. 33%, p = 0.046), specifically affecting the left main stem (16% vs. 1%, p < 0.001). PCI was performed in 81 patients (50%) without ROSC and in 295 (55%) with ROSC (p = 0.21). The success rate was 86% in patients without ROSC and 90% in patients with ROSC (p = 0.33). Thirty-day survival was 24% in patients without ROSC and 70% in patients with ROSC.
Conclusions: OHCA patients without ROSC on admission to hospital had higher acute coronary occlusion rates than patients with prehospital ROSC. PCI is feasible with a high success rate in patients without ROSC. Despite prolonged resuscitation times, meaningful survival in patients admitted without ROSC is achievable.
Details
- Title: Subtitle
- Coronary angiography and percutaneous coronary intervention in cardiac arrest patients without return of spontaneous circulation
- Creators
- Daniel Rob - Charles UniversityPetra Kavalkova - Charles UniversityJana Smalcova - Charles UniversityAles Kral - Charles UniversityTomas Kovarnik - General University Hospital in PragueDavid Zemanek - Charles UniversityOndrej FranekOndrej Smid - Charles UniversityStepan Havranek - Charles UniversityAles Linhart - General University Hospital in PragueJan Belohlavek - General University Hospital in Prague
- Resource Type
- Journal article
- Publication Details
- Resuscitation, Vol.175, pp.133-141
- Publisher
- Elsevier
- DOI
- 10.1016/j.resuscitation.2022.03.027
- PMID
- 35367316
- ISSN
- 0300-9572
- eISSN
- 1873-1570
- Number of pages
- 9
- Language
- English
- Date published
- 06/01/2022
- Academic Unit
- Electrical and Computer Engineering
- Record Identifier
- 9984627238502771
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