Circulation. Cardiovascular interventions
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Circ Cardiovasc Interv · Oct 2015
Predicting the Presence of an Acute Coronary Lesion Among Patients Resuscitated From Cardiac Arrest.
A mechanism to stratify patients resuscitated from a cardiac arrest according to the likelihood of an acute coronary lesion would have significant utility. We thus sought to develop and validate a risk prediction model for the presence of an acute coronary lesion among patients resuscitated from an arrest. ⋯ Patients with a cardiac arrest can be risk stratified for the presence of an acute coronary lesion using 4 easily measured variables. This simple risk score may be used to improve patient selection for emergent coronary angiography among resuscitated patients.
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Circ Cardiovasc Interv · Oct 2015
Early Coronary Angiography and Survival After Out-of-Hospital Cardiac Arrest.
Although out-of-hospital cardiac arrest is common because of acute myocardial infarction, it is unknown whether early coronary angiography is associated with improved survival in these patients. ⋯ Among initial survivors of out-of-hospital cardiac arrest caused by VF or pulseless VT, we found early coronary angiography was associated with higher odds of survival to discharge and favorable neurological outcome.
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Circ Cardiovasc Interv · Oct 2015
Clinical Trial Observational StudyPost-Resuscitation ECG for Selection of Patients for Immediate Coronary Angiography in Out-of-Hospital Cardiac Arrest.
We aimed to investigate coronary angiographic findings in unselected out-of-hospital cardiac arrest patients referred to immediate coronary angiography (ICA) irrespective of their first postresuscitation ECG and to determine whether this ECG is useful to select patients with no need of ICA. ⋯ Initial ECG findings are not reliable in detecting patients with an indication for ICA after experiencing a cardiac arrest. Even in the absence of ECG changes indicating myocardial ischemia, an acute culprit lesion may be present and patients may benefit from emergent revascularization. CLINICAL TRIAL REGISTRATIONURL: http://www.clinicaltrials.gov. Unique identifier: NCT01239420.
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Circ Cardiovasc Interv · Oct 2015
Immediate Percutaneous Coronary Intervention Is Associated With Improved Short- and Long-Term Survival After Out-of-Hospital Cardiac Arrest.
Whether 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. ⋯ Immediate 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.