• Resuscitation · Jun 2018

    Observational Study

    Association between coronary angiography with or without percutaneous coronary intervention and outcomes after out-of-hospital cardiac arrest.

    • Tyler F Vadeboncoeur, Vatsal Chikani, Chengcheng Hu, Danial W Spaite, and Bentley J Bobrow.
    • Department of Emergency Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu.
    • Resuscitation. 2018 Jun 1; 127: 21-25.

    AimThe aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE).MethodsProspective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010-12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network.ResultsAmong 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69-3.24) and for CAG plus PCI was 1.98 (95% CI 1.26-3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99-11.91) and for CAG plus PCI was 2.95 (95% CI 1.59-5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30-3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29-11.19).ConclusionIn OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.Copyright © 2018 Elsevier B.V. All rights reserved.

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