AI Article Synopsis
- The study analyzed the medical records of 697 patients who suffered out-of-hospital cardiac arrest (OHCA) between January 2012 and December 2020 to assess coronary angiography (CAG) findings and interventions.
- Among the patients, 23% did not have return of spontaneous circulation (ROSC) upon hospital admission, and those without ROSC were generally younger and experienced longer resuscitation times compared to those with ROSC.
- Although patients without ROSC had higher rates of acute coronary occlusions, PCI was still performed effectively, resulting in a notable but lower 30-day survival rate of 24%, compared to 70% in those with ROSC.
Article 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.
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| http://dx.doi.org/10.1016/j.resuscitation.2022.03.027 | DOI Listing |
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