Abstract 14079: Diagnostic Impact of the Finding From Study of Coronary Images in Acute Coronary Syndrome Patients With Out-of-Hospital Cardiac Arrest
Background: Acute coronary syndrome (ACS) is the major cause of out-of-hospital-cardiac-arrest (OHCA). The patients with ventricular fibrillation (VF) have more chance to get the return of spontaneous circulation (ROSC) and favorite neurological outcome by using defibrillator compared with pulseless electrical activity (PEA) and asystole.
The duration from collapse to ROSC is important in ACS patients with OHCA, but the relationship between the finding from study of coronary images and ROSC interval is still unknown.
Objective: We investigated the association between the finding from study of coronary images and ROSC interval in ACS patients with OHCA.
Methods: A cohort of 2779 patients was admitted to our emergency center due to cardiopulmonary arrest (CPA) from April 2011 to March 2015. We included the ACS patients who had CPA with VF as an initial rhythm, successfully resuscitated, underwent coronary angiography (CAG), had a culprit lesion, and needed percutaneous coronary intervention (PCI) (n=58, 63.7±12.0 years old, 93.1% male ).
We divided the 58 patients into 2 groups; early ROSC group (ROSC ≦20min: E-ROSC n=24) and late ROSC group (ROSC >20min: L-ROSC n=34), and analyzed their characteristics, respectively.
Results: Age was no significant difference between 2 groups (E-ROSC vs. L-ROSC; 64.8±14.3 vs. 63.0±10.2, p=0.54). E-ROSC group had higher incidence of female (17% vs. 0%), successful resuscitation by defibrillator (96% vs. 21%), and higher 30 days survival rate (96% vs. 41%) compared with L-ROSC group (all p<0.05).
The finding of collateral artery for the culprit lesion: Rentrop I-III and TIMI III flow in CAG on arrival were no significant differences between 2 groups (Rentrop I-III : 45.8% vs. 55.9% P=0.45; TIMI III: 33% vs. 59% P=0.88). Incidence of multi-vessel disease was lower in E-ROSC than L-ROSC (16.7% vs. 58.9% P=0.001).
Conclusion: Collateral and TIMI flow were not associated with ease of resuscitation, but multi-vessel disease may have a negative impact on resuscitation especially VF.
Author Disclosures: K. Tateishi: None. D. Abe: None. T. Iwama: None. T. Sassa: None. K. Ohashi: None. M. Kaneko: None. T. Harunari: None. Y. Yui: None. N. Kuroki: None. T. Yuba: None. K. Suzuki: None. Y. Hamabe: None.
- © 2015 by American Heart Association, Inc.