Feb 3, 2009

Acute coronary angiographic findings in survivors of out-of-hospital cardiac arrest

American Heart Journal
Zacharias Alexandros AnyfantakisPhilippe Gabriel Steg

Abstract

Diagnosis of acute coronary artery disease in survivors of out-of-hospital cardiac arrest (OHCA) is difficult. The role of emergency coronary angiography and percutaneous coronary intervention (PCI) in this setting is debated. The objective of this study was to assess the prevalence of coronary lesions on emergency angiography in survivors of OHCA. Seventy-two consecutive OHCA survivors underwent systematic emergency coronary angiography. Patients with critical stenoses or occlusion underwent ad hoc PCI. Most (63.9%) OHCA survivors had angiographic coronary artery disease (> or =1 lesion >50%), but only a minority (37.5%) had clinical or angiographic evidence of an acute coronary syndrome due to either an acute occlusion (16.7%) or an irregular lesion suggestive of ruptured plaque or thrombus (25.0%). A final diagnosis of myocardial infarction was assigned in 27 patients (37.5%). Percutaneous coronary intervention was attempted and successful in 33.3% of the total cohort (n = 24). Hospital survival was 48.6%. By multivariable analysis, use of PCI was not an independent correlate of survival. ST-segment elevation on admission was an independent correlate of acute myocardial infarction (odds ratio 64.2, 95% CI 7.6-544.2, P = .000...Continue Reading

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Citations

Mentioned in this Paper

Ventricular Fibrillation
Arterial System
Plaque, Atherosclerotic
Coronary Artery Disease
Fibrillation
Coronary Occlusion
Myocardial Infarction
Blastocyst Implantation, Natural
Acute Disease
Entire Coronary Artery

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