Abstract 336: Coronary Angiography in Cardiac Arrest Patients Without ST-Segment Elevation
Objectives: Guidelines advice early coronary angiography in patients suffering from out-of-hospital-cardiac-arrest (OHCA) without obvious extra-cardiac cause and ST-elevations in the ECG at hospital admission. Current opinions emphasize to go for early coronary angiography with all survivors without obvious extra-cardiac cause of OHCA. We matched these opinions with our local OHCA registry.
Methods: Prospectively collected data of 1,277 OHCA patients between 2005 and 2010 from a registry at a tertiary care university hospital were analysed for patients without obvious extra-cardiac cause and who have no ST-segment elevation or new left bundle branch block in the ECG at hospital admission.
Results: We could include 199 (15%) OHCA patients. During their hospital stay 90 (45%) patients got coronary angiography - 13 (7%) patients had intervention with stent implantation (PCI) and 8 (4%) patients got coronary artery bypass graft. Overall 115 (58%) patients survived one year with cerebral performance categories (CPC) 1 or 2.
In a subgroup of 39 (20%) prior healthy patients - defined as no known chronic medical conditions and no smokers prior to arrest - 23 (59%) got coronary angiography, 2 (7%) patients had PCI and 1 (3%) patient got coronary artery bypass graft. In this subgroup 28 (71%) patients survived one year with CPC 1/2.
Conclusion: Acute occlusion of a coronary artery seems to be just a part of underlying cardiac arrest cause in OHCA patients without ST-elevation in the ECG at emergency department admission. Even in the small subgroup of prior healthy patients occlusion of coronary artery does not be dominant reason for cardiac arrest. This study represents a small retrospective analysed population, therefor selection bias which patient got angiography must be presumed.
- Acute coronary syndromes
- Cardiac arrest
- Percutaneous coronary intervention (PCI)
- Ischemic heart disease
Author Disclosures: C. Weiser: None. C. Testori: None. C. Gangl: None. A. Schober: None. R. Van Tulder: None. F. Sterz: None.
- © 2014 by American Heart Association, Inc.