• Tanveer Rab, Karl B Kern, Jacqueline E Tamis-Holland, Timothy D Henry, Michael McDaniel, Neal W Dickert, Joaquin E Cigarroa, Matthew Keadey, Stephen Ramee, and Interventional Council, American College of Cardiology.
• Division of Cardiology, Emory University School of Medicine, Atlanta, Georgia. Electronic address: srab@emory.edu.
• J. Am. Coll. Cardiol. 2015 Jul 7;66(1):62-73.

AbstractPatients who are comatose after cardiac arrest continue to be a challenge, with high mortality. Although there is an American College of Cardiology Foundation/American Heart Association Class I recommendation for performing immediate angiography and percutaneous coronary intervention (when indicated) in patients with ST-segment elevation myocardial infarction, no guidelines exist for patients without ST-segment elevation. Early introduction of mild therapeutic hypothermia is an established treatment goal. However, there are no established guidelines for risk stratification of patients for cardiac catheterization and possible percutaneous coronary intervention, particularly in patients who have unfavorable clinical features in whom procedures may be futile and affect public reporting of mortality. An algorithm is presented to improve the risk stratification of these severely ill patients with an emphasis on consultation and evaluation of patients prior to activation of the cardiac catheterization laboratory.Copyright © 2015 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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