1. Early prognosis and predictor analysis for positive coronary angiography after out-of-hospital cardiac arrest (OHCA)
- Author
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Jacques Jamart, Vincent Dangoisse, Claude Hanet, Erwin Schroeder, Christophe de Meester de Ravenstein, Julien Higny, Antoine Guedes, and Laurence Gabriel
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Coronary angiography ,medicine.medical_specialty ,Resuscitation ,Acute coronary syndrome ,medicine.diagnostic_test ,business.industry ,Ischemia ,General Medicine ,030204 cardiovascular system & hematology ,medicine.disease ,Out of hospital cardiac arrest ,03 medical and health sciences ,0302 clinical medicine ,Internal medicine ,Diabetes mellitus ,Angiography ,Cardiology ,medicine ,In patient ,030212 general & internal medicine ,Cardiology and Cardiovascular Medicine ,business - Abstract
Background Key predictors of survival after OHCA have been described in the literature. Current guidelines recommend emergency angiography in patients without an obvious extra-cardiac cause of arrest. However, the value of this strategy is debated. Moreover, diagnosis of acute coronary ischaemia after OHCA remains challenging, especially in patients without ST-segment elevation. Objectives The primary objective was to identify qualitative variables associated with an increased chance of 30-d survival after OHCA. The secondary objective was to identify predictors of 30-d survival among patients with ischaemic cardiomyopathy and patients without ST-segment elevation. Afterwards, we sought to identify parameters associated with acute coronary ischaemia and positive coronary angiography in patients without ST-segment elevation. Methods Retrospective single-centre study including 123 patients resuscitated from OHCA. Baseline characteristics, resuscitation settings and angiographic findings were analysed. Results The predictors of 30-d survival after OHCA included witnessed cardiac arrest, haemodynamic instability and coronary angiography. Convertible cardiac rhythm, history of coronary disease and presence of at least two cardiovascular risk factors were associated with acute coronary ischaemia. Predictors for a positive angiography in patients without ST-segment elevation included history of coronary disease, gender, diabetes, dyslipidaemia and presence of at least two cardiovascular risk factors (all p Conclusions We identified qualitative predictors of 30-day survival after OHCA. Our findings suggest that the recognition of acute coronary ischaemia after OHCA might be improved. The identification of risk criteria may help to select the best candidates for emergency angiography.
- Published
- 2018
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