• Luca Raone, Marco Ferlini, Andrea Bongiorno, Sara Bendotti, Alessia Currao, Roberto Primi, Cristian Fava, Laura Dall'Oglio, Marianna Adamo, Daniele Ghiraldin, Marcello Marino, Andrea Baldo, Diego Maffeo, Vilma Kajana, Silvia Affinito, Enrico Baldi, LucaLeonardo DeLDivision of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy., and Simone Savastano.
• Division of Cardiology, Fondazione IRCCS Policlinico San Matteo, Pavia, Italy; Department of Molecular Medicine, University of Pavia, Pavia, Italy.
• Resuscitation. 2024 Dec 27; 206: 110471110471.

BackgroundMultivessel coronary artery disease (MVD) represents a common finding at invasive coronary angiography (ICA) among out-of-hospital cardiac arrest (OHCA) survivors. However, optimal invasive treatment strategy for MVD in OHCA remains unknown. Our study aims to assess if complete revascularization improves one-year clinical outcomes in these patients.MethodsThis is a multicentric, prospective, observational study. We considered all OHCA patients enrolled in the Lombardia CARe Registry from January 1, 2015, to December 31, 2022, who underwent ICA in 8 centers in Northern Italy. Clinical follow-up was performed 1 year after the index hospitalization.ResultsAmong the 13,354 OHCA patients enrolled, 863 were admitted to the 8 centers involved in the study and ICA was performed in 538 patients. MVD was present in 230 (42.7 %) patients, treated with either complete (77 patients) or incomplete (152 patients) coronary revascularization. At 1 year, death from any cause occurred in 20.8 % of the complete-revascularization group and 53.3 % of the culprit-lesion-only group (p < 0.001), while secondary-outcome event (death from any cause or unfavorable neurological outcome) occurred in 20.8 % and 55.9 %, respectively (p < 0.001). At multivariable analysis, a complete revascularization strategy was independently associated with a reduced risk of death [hazard ratio (HR) 0.29 (95 % confidence intervals (CI): 0.09 to 0.98; p = 0.047)] and death or unfavorable neurological outcome [HR: 0.23 (95 % CI: 0.06 to 0.81; p = 0.022)].ConclusionOur findings suggest that a complete percutaneous coronary revascularization strategy is associated with improved one-year survival rates in patients with MVD resuscitated from OHCA.Copyright © 2024 Elsevier B.V. All rights reserved.

7 keywords...

hide…