• Miguel A Maturana, Charles F Clinton, Selene Caballero-Cummings, Brandon Cave, Amal Khan, Amit Nanda, Devarshi Ardeshna, Joel Raja, and Rami N Khouzam.
• Department of Internal Medicine, University of Tennessee Health Science Center, Memphis, TN, USA.
• Ann Transl Med. 2019 Sep 1; 7 (17): 413.

AbstractOut-of-hospital cardiac arrest (OHCA) is the leading cause of death in the United States, as 90% of them are fatal per the 2018 American Heart Association statistics. As many as fifty-percent of cardiac arrest events display an initial rhythm of pulseless ventricular tachycardia (pVT) and ventricular fibrillation (VF), and of those, coronary artery disease (CAD) is found in 60-80% of patients. Following return of spontaneous circulation, patients who present with ST-elevation myocardial infarction (STEMI) should undergo an early invasive strategy and primary intervention, which is well-established guideline-based management. The support of such a strategy in patients suspected to have underlying cardiac cause but without ST-elevation has been waxing and waning in the literature. The Coronary Angiography after Cardiac Arrest (COACT) trial was designed to compare survival between an immediate or delayed coronary angiography strategy in non-STEMI (NSTEMI) OHCA patients, following successful resuscitation. We present a systematic review of the history of management strategies in OHCA and propose guidelines to manage such patients in light of the COACT trial.2019 Annals of Translational Medicine. All rights reserved.

4 keywords...

hide…