AIMS: On-admission coronary angiogram (CA) with angioplasty (percutaneous coronary intervention, PCI) may improve survival in patients resuscitated from out-of-hospital cardiac arrest (OHCA), but long-term survival data are scarce. We assessed long-term survival in OHCA patients managed with on-admission CA and PCI if indicated and compared survival rates in patients with/without acute coronary syndrome (ACS). METHODS: Retrospective single-centre study including patients aged ≥18 years resuscitated from an OHCA without noncardiac cause, with sustained return of spontaneous circulation, undergoing on-admission CA with PCI if indicated. ACS was diagnosed angiographically. Survival was recorded at hospital discharge and at 5-year follow up. Survival probability was estimated by Kaplan-Meier survival curves. RESULTS: A total of 300 comatose patients aged 56 years (IQR 48-67 years) were included, 36% with ST-segment elevation. All had on-admission CA; 31% had ACS. PCI was attempted in 91% of ACS patients and was successful in 93%. Hypothermia was performed in 84%. Survival to discharge was 32.3%. After discharge, 5-year survival was 81.7 ± 5.4%. Survival from admission to 5 years was 26.2 ± 2.8%. ACS patients had better survival to discharge (40.8%) compared with non-ACS patients (28.5%, p=0.047). After discharge, 5-year survival was 92.2 ± 5.4% for patients with ACS and 73.4 ± 8.6% without ACS (hazard ratio, HR, 2.7, 95% CI 0.8-8.9, p=0.1). Survival from admission to 5 years was 37.4 ± 5.2% for ACS patients, 20.7 ± 3.0%, for non-ACS patients (HR 1.5, 95% CI 1.12-2.0, p=0.0067). CONCLUSIONS: OHCA patients undergoing on-admission CA had a very favourable postdischarge survival. Patients with OHCA due to ACS had better survival to discharge at 5-year follow up than patients with OHCA due to other causes.
AIMS: On-admission coronary angiogram (CA) with angioplasty (percutaneous coronary intervention, PCI) may improve survival in patients resuscitated from out-of-hospital cardiac arrest (OHCA), but long-term survival data are scarce. We assessed long-term survival in OHCA patients managed with on-admission CA and PCI if indicated and compared survival rates in patients with/without acute coronary syndrome (ACS). METHODS: Retrospective single-centre study including patients aged ≥18 years resuscitated from an OHCA without noncardiac cause, with sustained return of spontaneous circulation, undergoing on-admission CA with PCI if indicated. ACS was diagnosed angiographically. Survival was recorded at hospital discharge and at 5-year follow up. Survival probability was estimated by Kaplan-Meier survival curves. RESULTS: A total of 300 comatosepatients aged 56 years (IQR 48-67 years) were included, 36% with ST-segment elevation. All had on-admission CA; 31% had ACS. PCI was attempted in 91% of ACS patients and was successful in 93%. Hypothermia was performed in 84%. Survival to discharge was 32.3%. After discharge, 5-year survival was 81.7 ± 5.4%. Survival from admission to 5 years was 26.2 ± 2.8%. ACS patients had better survival to discharge (40.8%) compared with non-ACS patients (28.5%, p=0.047). After discharge, 5-year survival was 92.2 ± 5.4% for patients with ACS and 73.4 ± 8.6% without ACS (hazard ratio, HR, 2.7, 95% CI 0.8-8.9, p=0.1). Survival from admission to 5 years was 37.4 ± 5.2% for ACS patients, 20.7 ± 3.0%, for non-ACS patients (HR 1.5, 95% CI 1.12-2.0, p=0.0067). CONCLUSIONS: OHCA patients undergoing on-admission CA had a very favourable postdischarge survival. Patients with OHCA due to ACS had better survival to discharge at 5-year follow up than patients with OHCA due to other causes.
Authors: Simon A Amacher; Chantal Bohren; René Blatter; Christoph Becker; Katharina Beck; Jonas Mueller; Nina Loretz; Sebastian Gross; Kai Tisljar; Raoul Sutter; Christian Appenzeller-Herzog; Stephan Marsch; Sabina Hunziker Journal: JAMA Cardiol Date: 2022-06-01 Impact factor: 30.154
Authors: Demetris Yannopoulos; Jason Bartos; Ganesh Raveendran; Emily Walser; John Connett; Thomas A Murray; Gary Collins; Lin Zhang; Rajat Kalra; Marinos Kosmopoulos; Ranjit John; Andrew Shaffer; R J Frascone; Keith Wesley; Marc Conterato; Michelle Biros; Jakub Tolar; Tom P Aufderheide Journal: Lancet Date: 2020-11-13 Impact factor: 79.321
Authors: Julien Adjedj; Fabien Picard; Maarten Vanhaverbeke; Bernard De Bruyne; Alain Cariou; Ming Wu; Stefan Janssens; Olivier Varenne Journal: Intensive Care Med Exp Date: 2018-10-12