Min-Shan Tsai1, Chih-Wei Sung2, Wen-Jone Chen3, Po-Ya Chuang4, Chih-Hung Wang1, Yen-Wen Wu5, Wei-Tien Chang1, Wei-Ting Chen1, Chien-Hua Huang6. 1. Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan. 2. Department of Emergency Medicine, National Taiwan University Hospital Hsin-Chu Branch, Hsinchu, Taiwan. 3. Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan; Department of Internal Medicine (Cardiology division), National Taiwan University Medical College and Hospital, Taipei, Taiwan. Electronic address: wjchen1955@ntu.edu.tw. 4. School of Health Care Administration, Taipei Medical University, Taipei, Taiwan. 5. Department of Nuclear Medicine, Cardiology Division of Cardiovascular Medical Center, Far Eastern Memorial Hospital, New Taipei City, Taiwan. 6. Department of Emergency Medicine, National Taiwan University Medical College and Hospital, Taipei, Taiwan. Electronic address: chhuang730@gmail.com.
Abstract
BACKGROUND: The emergent coronary angiography (CAG) is associated with better outcomes in CA survivors. However, the impact of severity and revascularization of coronary artery stenosis on outcomes in cardiac arrest (CA) survivors remains unclear. METHODS: A total of 273 non-traumatic adult CA survivors who underwent emergent CAG from January 2011 to July 2017 were retrospectively recruited. The stenosis and non-revascularization of an individual coronary artery ≥70% were defined as significant in any of the major coronary arteries based on an operator visual estimate. RESULTS: There were 201 patients (73.63%) had ≧1 significant coronary artery stenosis and 58 patients (21.25%) with ≧1 non-revascularized coronary artery. The increased number of stenosed coronary artery was associated with an increased risk for in-hospital mortality [1-vessel: adjusted hazard ration (HR) 2.27, 95% confidence interval (CI) = 1.43-4.04, p = 0.021; 2-vessel: adjusted HR 5.49, 95% CI=2.17-13.89, p < 0.001; 3-vessel: adjusted HR 11.05, 95% CI=4.20-29.04, p < 0.001)] and poor neurological recovery (cerebral performance category = 3-5) [(1-vessel: adjusted odds ration (OR) 1.66, 95% CI 0.67-4.15, =0.275; 2-vessel: adjusted OR 1.81, 95% CI 1.05-3.97, p = 0.045; 3-vessel: adjusted OR 3.19, 95% CI 1.25-8.15, p = 0.001)], which was positively correlated with the number of vessels. The incomplete revascularization were also associated with increased in-hospital mortality and poor neurological function in patients with ≧1vessel stenosis. CONCLUSION: The severity and incomplete revascularization of coronary artery stenosis were associated with increased in-hospital mortality and poor neurological recovery in patients with presumed cardiogenic arrest.
BACKGROUND: The emergent coronary angiography (CAG) is associated with better outcomes in CA survivors. However, the impact of severity and revascularization of coronary artery stenosis on outcomes in cardiac arrest (CA) survivors remains unclear. METHODS: A total of 273 non-traumatic adult CA survivors who underwent emergent CAG from January 2011 to July 2017 were retrospectively recruited. The stenosis and non-revascularization of an individual coronary artery ≥70% were defined as significant in any of the major coronary arteries based on an operator visual estimate. RESULTS: There were 201 patients (73.63%) had ≧1 significant coronary artery stenosis and 58 patients (21.25%) with ≧1 non-revascularized coronary artery. The increased number of stenosed coronary artery was associated with an increased risk for in-hospital mortality [1-vessel: adjusted hazard ration (HR) 2.27, 95% confidence interval (CI) = 1.43-4.04, p = 0.021; 2-vessel: adjusted HR 5.49, 95% CI=2.17-13.89, p < 0.001; 3-vessel: adjusted HR 11.05, 95% CI=4.20-29.04, p < 0.001)] and poor neurological recovery (cerebral performance category = 3-5) [(1-vessel: adjusted odds ration (OR) 1.66, 95% CI 0.67-4.15, =0.275; 2-vessel: adjusted OR 1.81, 95% CI 1.05-3.97, p = 0.045; 3-vessel: adjusted OR 3.19, 95% CI 1.25-8.15, p = 0.001)], which was positively correlated with the number of vessels. The incomplete revascularization were also associated with increased in-hospital mortality and poor neurological function in patients with ≧1vessel stenosis. CONCLUSION: The severity and incomplete revascularization of coronary artery stenosis were associated with increased in-hospital mortality and poor neurological recovery in patients with presumed cardiogenic arrest.
Authors: Sébastien Redant; Yael Langman; Xavier Beretta-Piccoli; David De Bels; Rachid Attou; Patrick M Honore Journal: Crit Care Date: 2019-11-27 Impact factor: 9.097
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