Mar 27, 2009

Coronary angiography predicts improved outcome following cardiac arrest: propensity-adjusted analysis

Journal of Intensive Care Medicine
Joshua C ReynoldsJon C Rittenberger


Determine if clinical parameters of resuscitated patients predict coronary angiography (CATH) performance and if receiving CATH after cardiac arrest is associated with outcome. CATH is associated with survival in patients suffering out-of-hospital cardiac arrest (OHCA) from ventricular fibrillation or ventricular tachycardia(VF/VT). Its effect on outcome in other cohorts is unknown. Chart review of resuscitated cardiac arrest patients between 2005 and 2007. immediate withdrawal of care, hemodynamic collapse, or neurologic exam under sedation. Clinical parameters included Glasgow Coma Scale (GCS) arrest location, presenting rhythm, age, and acute ischemic ECG changes (new left bundle branch block or ST-elevation myocardial infarction-STEMI). Logistic regression identified clinical parameters predicting CATH. The association between CATH and good outcome (discharge home or to acute rehabilitation facility) was determined using logistic regression adjusting for likelihood of receiving CATH via propensity score. Of the 241 patients, 96 (40%) received CATH. Significant disease (>or=70% stenosis) of >or=1 coronary arteries was identified in 69% of patients including 57% of patients without acute ischemic ECG changes. Unadjusted predi...Continue Reading

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Mentioned in this Paper

Ventricular Fibrillation
Left Bundle-Branch Block
Bundle-Branch Block
Myocardial Infarction
Stenosis (invertebrate)
Coronary Artery
Tachycardia, Ventricular
Acquired Stenosis
Procedures on Coronary Arteries

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