Youn-Jung Kim1, Yong Hwan Kim2, Byung Kook Lee3, Yoo Seok Park4, Min Seob Sim5, Su Jin Kim6, Sang Hoon Oh7, Dong Hoon Lee8, Won Young Kim9. 1. Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea. 2. Departments of Emergency Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, Republic of Korea. 3. Department of Emergency Medicine, Chonnam National University Hospital, Gwangju, Republic of Korea. 4. Department of Emergency Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea. 5. Department of Emergency Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Republic of Korea. 6. Department of Emergency Medicine, College of Medicine, Korea University, Seoul, Republic of Korea. 7. Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea. 8. Department of Emergency Medicine, Chung-Ang University, College of Medicine, Seoul, Republic of Korea. 9. Department of Emergency Medicine, Ulsan University College of Medicine, Asan Medical Center, Seoul, Republic of Korea. Electronic address: wonpia73@naver.com.
Abstract
AIM: The optimal coronary angiography (CAG) timing in out-of-hospital cardiac arrest (OHCA) survivors without ST-segment elevation (STE) for good neurologic outcome remains unknown. This study aimed to evaluate whether immediate versus early CAG impacts neurological outcomes of OHCA survivors without STE. METHODS: This multicenter retrospective observational registry-based study was conducted at the emergency department (ED) of 8 Korean tertiary care hospitals. Data of adult non-traumatic OHCA patients with no obvious extra-cardiac cause, without STE, who were treated with targeted temperature management (TTM), and in whom CAG was performed within 24 h after return of spontaneous circulation between 2010 and 2015 were extracted. Patients in the immediate (≤2 h) and early (2-24 h) CAG groups were propensity score matched. The primary endpoint was 1-month good neurological outcomes. RESULTS: Among 346 patients with TTM and CAG, 119 who underwent CAG after 24 h were excluded, leaving 112 and 115 in the immediate and early CAG groups, respectively. Median time to CAG was 120.0 (70.0-224.0) minutes; 97 (42.7%) patients had significant coronary artery stenosis. Good neurological outcome was higher in the early versus immediate CAG group (50.4% vs. 31.3%, P = 0.003), but no significant intergroup difference persisted after matching. CAG timing was not associated with good neurological outcomes (odds ratio, 1.917; 95% confidence interval, 0.954-3.852; P = 0.07). CONCLUSIONS: Coronary artery stenosis was found in 42.7% of TTM-treated non-STE OHCA patients with CAG within 24 h, but there was no clear neurological benefit of immediate versus early CAG.
AIM: The optimal coronary angiography (CAG) timing in out-of-hospital cardiac arrest (OHCA) survivors without ST-segment elevation (STE) for good neurologic outcome remains unknown. This study aimed to evaluate whether immediate versus early CAG impacts neurological outcomes of OHCA survivors without STE. METHODS: This multicenter retrospective observational registry-based study was conducted at the emergency department (ED) of 8 Korean tertiary care hospitals. Data of adult non-traumatic OHCApatients with no obvious extra-cardiac cause, without STE, who were treated with targeted temperature management (TTM), and in whom CAG was performed within 24 h after return of spontaneous circulation between 2010 and 2015 were extracted. Patients in the immediate (≤2 h) and early (2-24 h) CAG groups were propensity score matched. The primary endpoint was 1-month good neurological outcomes. RESULTS: Among 346 patients with TTM and CAG, 119 who underwent CAG after 24 h were excluded, leaving 112 and 115 in the immediate and early CAG groups, respectively. Median time to CAG was 120.0 (70.0-224.0) minutes; 97 (42.7%) patients had significant coronary artery stenosis. Good neurological outcome was higher in the early versus immediate CAG group (50.4% vs. 31.3%, P = 0.003), but no significant intergroup difference persisted after matching. CAG timing was not associated with good neurological outcomes (odds ratio, 1.917; 95% confidence interval, 0.954-3.852; P = 0.07). CONCLUSIONS:Coronary artery stenosis was found in 42.7% of TTM-treated non-STE OHCA patients with CAG within 24 h, but there was no clear neurological benefit of immediate versus early CAG.
Authors: Meng-Chang Yang; Wu Meng-Jun; Xu Xiao-Yan; Kevin L Peng; Yong G Peng; Ru-Rong Wang Journal: Medicine (Baltimore) Date: 2020-10-09 Impact factor: 1.889
Authors: Hwan Song; Hyo Joon Kim; Kyu Nam Park; Soo Hyun Kim; Won Young Kim; Byung Kook Lee; In Soo Cho; Jae Hoon Lee; Chun Song Youn Journal: J Clin Med Date: 2021-01-23 Impact factor: 4.241
Authors: Dong Ki Kim; Yong Soo Cho; Joochan Kim; Byung Kook Lee; Dong Hun Lee; Eujene Jung; Jeong Mi Moon; Byeong Jo Chun Journal: Acute Crit Care Date: 2020-12-21
Authors: Enrico Baldi; Sebastian Schnaubelt; Maria Luce Caputo; Catherine Klersy; Christian Clodi; Jolie Bruno; Sara Compagnoni; Claudio Benvenuti; Hans Domanovits; Roman Burkart; Rosa Fracchia; Roberto Primi; Gerhard Ruzicka; Michael Holzer; Angelo Auricchio; Simone Savastano Journal: JAMA Netw Open Date: 2021-01-04