Tyler F Vadeboncoeur1, Vatsal Chikani2, Chengcheng Hu3, Danial W Spaite4, Bentley J Bobrow5. 1. Department of Emergency Medicine, Mayo Clinic, 4500 San Pablo Road, Jacksonville, FL, 32224, United States. Electronic address: Vadeboncoeur.tyler@mayo.edu. 2. The Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System, Phoenix, AZ, United States. Electronic address: vatsal.chikani@azdhs.gov. 3. Arizona Emergency Medicine Research Center, The University of Arizona College of Medicine, Tucson, AZ, United States. Electronic address: hucc@email.arizona.edu. 4. Arizona Emergency Medicine Research Center, The University of Arizona College of Medicine, Tucson, AZ, United States. Electronic address: dan@aemrc.arizona.edu. 5. The Arizona Department of Health Services Bureau of Emergency Medical Services and Trauma System, Phoenix, AZ, United States; Arizona Emergency Medicine Research Center, The University of Arizona College of Medicine, Tucson, AZ, United States; The University of Arizona Sarver Heart Center, Tucson, AZ, United States. Electronic address: bobrowb@azdhs.gov.
Abstract
AIM: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). METHODS: Prospective 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. RESULTS: Among 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). CONCLUSION: In 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.
AIM: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). METHODS: Prospective 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. RESULTS: Among 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). CONCLUSION: In 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.
Authors: Matthias Mueller; Daniela Dziekan; Michael Poppe; Christian Clodi; Christoph Schriefl; Martin Hofbauer; Christian Roth; Alexander Nuernberger; Michael Holzer; Christoph Weiser Journal: Wien Klin Wochenschr Date: 2021-06-30 Impact factor: 1.704