• Guillaume Geri, Florence Dumas, Wulfran Bougouin, Olivier Varenne, Fabrice Daviaud, Frédéric Pène, Lionel Lamhaut, Jean-Daniel Chiche, Christian Spaulding, Jean-Paul Mira, Jean-Philippe Empana, and Alain Cariou.
• From the Medical Intensive Care Unit (G.G., W.B., F. Daviaud, F.P., J.-D.C., J.-P.M., A.C.), Emergency Department (F. Dumas), and Cardiology Department (O.V.), Cochin Hospital, Assistance Publique Hôpitaux de Paris; Emergency Medical Service, SAMU 75 (L.L.); INSERM, UMR-S970, Paris Cardiovascular Research Centre, Department of Epidemiology, Paris, France (G.G., F. Dumas, W.B., L.L., C.S., J.-P.E., A.C.); Université Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine, Paris, France (G.G., F. Dumas, W.B., O.V., F. Daviaud, F.P., L.L., J.-D.C., C.S., J.-P.M., J.-P.E., A.C.); Sudden Death Expertise Center, Paris, France (G.G., F. Dumas, W.B., L.L., C.S., J.-P.E., A.C.); and Cardiology Department, European Georges Pompidou Hospital, Assistance Publique Hôpitaux de Paris (C.S.).
• Circ Cardiovasc Interv. 2015 Oct 1; 8 (10).

BackgroundWhether to perform or not an immediate percutaneous coronary intervention (PCI) after out-of-hospital cardiac arrest is still debated. We aimed to evaluate the impact of PCI on short- and long-term survival in out-of-hospital cardiac arrest patients admitted after successful resuscitation.Methods And ResultsBetween 2000 and 2013, all nontrauma out-of-hospital cardiac arrest patients admitted in a Parisian cardiac arrest center after return of spontaneous circulation were prospectively included. The association between immediate PCI and short- and long-term mortality was analyzed using logistic regression and Cox multivariate analysis, respectively. Propensity score-matching method was used to assess the influence of PCI on short- and long-term survival. During the study period, 1722 patients (71.5% male, median age 60 [49.6, 72.2] years) were analyzed: 628 (35.6%) without coronary angiography, 615 (35.7%) with coronary angiography without PCI, and 479 (27.8%) with both. Among these groups, day 30 and year-10 survival rates were 21% and 11.9%, 35% and 29%, 43% and 38%, respectively (P<0.01 for each). PCI as compared with no coronary angiography was associated with a lower day-30 and long-term mortality (adjORcoro with PCI versus no coro 0.71, 95% confidence interval [0.54, 0.92]; P=0.02 and adjHRcoro with PCI versus no coro 0.44, 95% confidence interval [0.27, 0.71]; P<0.01, respectively). PCI remained associated with a lower risk of long-term mortality (adjHR 0.29; 95% confidence interval [0.14, 0.61]; P<0.01) in propensity score-matching analysis.ConclusionsImmediate PCI after out-of-hospital cardiac arrest was associated with significant reduced risk of short- and long-term mortality. These findings should suggest physicians to consider immediate coronary angiography and PCI if indicated in these patients.© 2015 American Heart Association, Inc.

22 keywords...

hide…