Abstract 163: Does Primary Coronary Angioplasty Improve Outcome in Patients Who Are Victims of Out-of-Hospital Cardiac Arrest?
Introduction: Patients presenting with out of hospital cardiac arrest (OHCA) and no evidence of extra-cardiac cause have a catastrophic short term outcome. Identifying predictors of improved survival is crucial in this population.
Methods and population: The purpose of our retrospective observational study is to evaluate the role of primary coronary angioplasty (PCI) on in-hospital survival in patients victims of OHCA.
Results A total of 79 patients (Pts) were enrolled in our center between January 2008 and December 2010. Mean age was 62 ± 7 years (20 to 91) and 57 (72%) were men. The CPR was bystander initiated in 29 cases (47%) and no flow period was 5 ± 6 (0 to 30) minutes. Adrenaline was used in 66 (84%) of Pts and defibrillation was required in 50 (63%). Time from cardiac arrest to recovery was 26 ± 14 minutes. Coronary angiography was performed in 41 Pts (52 %). Significant (> 50% stenosis) coronary artery lesions were observed in 31 (76%) Pts leading to PCI in 23 Pts. Mild hypothermia was induced in 65% of Pts and was not delayed by the PCI procedure (10.7 vs 8.1 hours, p = 0,1). Bystander initiated CPR (p< 0.001), the use of adrenalin during resuscitation (p< 0.0001), a defibrillation (p< 0.001), a no flow < 5 min (p< 0.001), a time for cardiac arrest to recovery <15 min (p< 0.001) were significantly correlated to improved survival. PCI alone did not improve survival: 43% vs 25% (p=0.67). However, in Pts with anterior STEMI treated by PCI, mild hypothermia was associated with a better outcome : 66% vs 0%, (p=0.03).
Conclusion: A strategy of coronary angioplasty associated with an early hypothermia appears to be correlated with an improved survival in patients presenting with out of hospital cardiac arrest complicating an anterior myocardial infarction.
- © 2011 by American Heart Association, Inc.