Abstract 10305: Clinical and Angiographic Characteristics of Patients Undergoing Percutaneous Coronary Intervention Following Sudden Cardiac Arrest: Insights From the NCDR®
Background: Coronary artery disease is present in the majority of out-of-hospital sudden cardiac arrest (SCA) patients (pts), and acute myocardial infarction (MI) is the most common cause of sudden cardiac death. To date, most studies are limited to primarily single center sites, with relatively few pts included. In the present study we describe the characteristics of a large consecutive group of pts undergoing percutaneous coronary intervention (PCI) following SCA.
Methods: We included consecutive SCA pts enrolled in the CathPCI Registry® who underwent PCI within 24 hours of admission, and compared them to pts having PCI without SCA. Pts were further categorized as having STEMI or No STEMI. Categorical variables were summarized using percentages and compared using Mantel-Haenszel chi-square tests while continuous variables were presented using median and compared using Wilcoxon rank sum test.
Results: A total of 16,394 SCA pts underwent coronary angiography, of whom 12,150 (74%; 9375 STEMI, 2775 No-STEMI) had PCI. SCA pts were similar in age to non-SCA pts, with a lower frequency of coronary disease risk factors and known coronary disease (table). On angiography, SCA pts had more complex lesions with worse baseline TIMI flow. In addition, outcomes were substantially worse in SCA pts for both STEMI and No-STEMI pts, with more complications and higher mortality.
Conclusions: In the Cath/PCI Registry, pts with SCA undergoing PCI had more complex anatomy, more shock, and worse outcomes, including bleeding, stroke and death. The substantially increased adverse outcomes in SCA pts have important implications for the development and regionalization of centers for SCA.
- © 2011 by American Heart Association, Inc.