Abstract 150: Impact of Emergency Recanalization and Mild Hypothermia Therapy: Analysis of ST Segment of Electrocardiogram Following Recovery of Spontaneous Circulation After Cardiac Arrest
(Background) Recently published guideline recommended emergency angiography with prompt recanalization in the patients with ST elevation myocardial infarction (STEMI) as class I indication following recovery of spontaneous circulation (ROSC) after cardiac arrest, however, the recanalization in the absence of clearly defined STEMI after ROSC was not yet definitely recommended. The purpose of this study was to evaluate mortality and favorable neurologic outcomes (cerebral performance category [CPC] 1 and 2) at 30 days between the pts with ST elevation and those without ST elevation of electrocardiogram (ECG) immediately after ROSC undergoing percutaneous coronary intervention (PCI) with mild hypothermia (MHT).
(Method) Data over a five-year period (2005-2009) were obtained for 452 pts treated with MHT from a multicenter registry in Japan. Of these patients, the 145 pts (who can be obtained ECG after ROSC) were diagnosed with acute ischemia by emergency angiography immediately after ROSC, and were subsequently treated with MHT and PCI.
(Result) The 145 pts were divided into two groups based on the ECG after ROSC; ST elevation groups (STE) (n=95): ST elevation (n=94) and CLBBB (n=1), and Non ST elevation groups (NSTE) (n=50): ST depression (n=26), equivocal due to wide QRS complex (n=14), and almost normal ECG (n=10). Mortality rates at 30 days were 16.8% in STE group and 16.0% in NSTE group (p=0.8968). Favorable outcome rates at 30 days were 60.0% in STE group and 66.0% (p=0.4791) in NSTE group.
(Conclusion) PCI with MHT were equally effective for 30 days mortality and favorable neurologic outcome for the pts with any ST segment type of ECG immediately after ROSC.
- © 2011 by American Heart Association, Inc.