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Catheter Cardiovasc Interv · Jan 2019
Multicenter Study Observational StudyAngiographic characteristics and long-term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non-diagnostic electrocardiogram.
- María Teresa Nogales-Romo, Carlos Ferrera, Pablo Salinas, Pedro Martínez-Losas, Luis Nombela-Franco, Iván Javier Núñez-Gil, Francisco Javier Noriega, María Del Trigo, Nieves Gonzalo, Pilar Jiménez-Quevedo, Javier Escaned, Antonio Fernández-Ortiz, Carlos Macaya, and Ana Viana-Tejedor.
- Department of Cardiology, Cardiovascular Institute, Hospital Clínico San Carlos, Madrid, Spain.
- Catheter Cardiovasc Interv. 2019 Jan 1; 93 (1): 9-15.
ObjectivesOur purpose was to describe the prevalence, distribution, extension, and prognostic value of coronary artery disease (CAD) in patients resuscitated from sudden cardiac arrest (SCA) with non-diagnostic electrocardiogram (ECG).BackgroundThe impact of CAD and the indication for cardiac catheterization (CC) in patients resuscitated from SCA with non-diagnostic ECG are uncertain.MethodsWe included prospectively and consecutively 545 patients resuscitated from SCA with at least one CC during hospitalization. From them, 203 patients with a non-diagnostic ECG formed our study population. Patients were followed-up 5 years after discharge.ResultsOverall, 125 (61.6%) patients had significant CAD, and at least one acute culprit lesion was found in 25 (12.4%). Regarding the burden and complexity of CAD, 78 (38.4%) patients had a CAD Prognostic Index of 0 and a SYNTAX score of 0. There was higher 5-year mortality only in patients with very high burden of CAD: three vessels with severe stenosis (P = 0.015) and CAD Prognostic Index Score ≥ 56 (P < 0.001). Tertiles of SYNTAX score did not predict higher 5-year mortality.ConclusionsIn survivors from SCA with a non-diagnostic ECG, significant CAD is highly prevalent. SYNTAX score was not associated with a different long-term prognosis in this patient population. Patients with severe disease in the three main coronary vessels and patients with higher (≥56) CAD Prognostic Index Score had a worse long-term prognosis.© 2018 Wiley Periodicals, Inc.
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