• Resuscitation · Apr 2019

    Multicenter Study

    Stenosis and revascularization of the coronary artery are associated with outcomes in presumed cardiogenic arrest survivors: A multi-center retrospective cohort study.

    • Min-Shan Tsai, Chih-Wei Sung, Wen-Jone Chen, Po-Ya Chuang, Chih-Hung Wang, Yen-Wen Wu, Wei-Tien Chang, Wei-Ting Chen, and Chien-Hua Huang.
    • Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan.
    • Resuscitation. 2019 Apr 1; 137: 52-60.

    BackgroundThe emergent coronary angiography (CAG) is associated with better outcomes in CA survivors. However, the impact of severity and revascularization of coronary artery stenosis on outcomes in cardiac arrest (CA) survivors remains unclear.MethodsA total of 273 non-traumatic adult CA survivors who underwent emergent CAG from January 2011 to July 2017 were retrospectively recruited. The stenosis and non-revascularization of an individual coronary artery ≥70% were defined as significant in any of the major coronary arteries based on an operator visual estimate.ResultsThere were 201 patients (73.63%) had ≧1 significant coronary artery stenosis and 58 patients (21.25%) with ≧1 non-revascularized coronary artery. The increased number of stenosed coronary artery was associated with an increased risk for in-hospital mortality [1-vessel: adjusted hazard ration (HR) 2.27, 95% confidence interval (CI) = 1.43-4.04, p = 0.021; 2-vessel: adjusted HR 5.49, 95% CI=2.17-13.89, p < 0.001; 3-vessel: adjusted HR 11.05, 95% CI=4.20-29.04, p < 0.001)] and poor neurological recovery (cerebral performance category = 3-5) [(1-vessel: adjusted odds ration (OR) 1.66, 95% CI 0.67-4.15, =0.275; 2-vessel: adjusted OR 1.81, 95% CI 1.05-3.97, p = 0.045; 3-vessel: adjusted OR 3.19, 95% CI 1.25-8.15, p = 0.001)], which was positively correlated with the number of vessels. The incomplete revascularization were also associated with increased in-hospital mortality and poor neurological function in patients with ≧1vessel stenosis.ConclusionThe severity and incomplete revascularization of coronary artery stenosis were associated with increased in-hospital mortality and poor neurological recovery in patients with presumed cardiogenic arrest.Copyright © 2019 Elsevier B.V. All rights reserved.

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