Abstract 12088: Coronary Angiography and Revascularization After Out-of-Hospital Cardiac Arrest in Coronary Artery Disease Patients Without ST-segment Elevation

Abstract

Introduction: The emergent coronary angiography and revascularization after out-of-hospital cardiac arrest (OHCA) in coronary artery disease (CAD) patients without ST-segment elevation remains controversial. Methods: There were 2391OHCA patients transferred to 2 hospitals. We included 405 cardiovascular arrest patients, who got return of spontaneous circulation (ROSC) from January 2015 to December 2018. Among them, 110 patients were diagnosed CAD with no ST-segment elevation in electro-cardiogram (51%: multi-vessel disease, 33%: chronic total occlusion). To predict mortality in hospital and neurological outcome at 1-year, we investigated basic patients’ characteristics, pre-hospital information, post-hospital care including coronary angiography (CAG) and revascularization. Results: In the Cox proportional hazards model, emergent coronary angiography (hazards ratio; HR: 0.90, 95%confidence interval (CI) 0.45-1.79, P=0.758) and emergent coronary revascularization (HR: 1.51, 95%CI 0.87-2.61, P=0.142) were not associated to predict the mortality. At 1-year, VF survivor (P=0.004), younger age (P=0.010), without ECMO support (P<0.001), pre-hospital ROSC (P<0.001), and low lactate level on admission (P<0.001) were associated with low mortality. The higher number of coronary vessel disease (P=0.020) such as multi-vessel disease (P=0.019), the coronary lesion of LAD (P=0.043), and larger infarct size (max CK level; P=0.014, max CK-MB level; P<0.001) were associated with high 1-year mortality. Zero-vessel disease (VSA, P=0.007) had lower mortality. Conclusions: Emergent coronary assessment and revascularization were not associated with the prognosis.