Abstract
Coronary artery disease (CAD) is the leading cause of OHCA. However, diagnosis of ACI remains challenging, particularly in patients without ST-segment elevation on the post-resuscitation ECG. In this regard, a consensus statement recommends the implementation of a work-up strategy in the emergency room (ER) to exclude non-coronary causes of collapse within 2 hours. We present data on coronary angiograms for patients who underwent cardiac catheterization after resuscitation. Afterwards, we sought to identify parameters associated with ACI. Retrospective single-centre study performed on 64 consecutive patients with resuscitated OHCA who underwent a diagnostic coronary angiography (CA). Data collection was performed from the patient records at the ER and the catheterization laboratory. ST-segment elevation was noted in 29 patients (45%). ST-segment depression or T-wave abnormalities were noted in 35 patients (55%). Invasive coronary strategy allowed to identify an acute culprit lesion in 46 cases (72%). 29 patients with ST-segment elevation underwent an immediate angioplasty for an acute coronary occlusion. 17 patients without ST-segment elevation underwent an ad hoc percutaneous coronary intervention for a critical lesion. Stable CAD was found in 9 cases (14%) and a normal angiogram was found in only 9 cases (14%) ( Fig. 1 ). The independent predictors of ACI were convertible rhythm (OR 16.02; 95% CI 4.48–57.29), personal history of CAD (OR 15.12; 95% CI 4.19–54.53) and presence of at least 2 cardiovascular risk factors (OR 10.68; 95% CI 2.55–44.74) ( Table 1 ). ACI was the leading precipitant of collapse. ST-segment elevation was highly predictive of coronary occlusion. A culprit coronary lesion was identified in nearly 50% of patients undergoing CA despite the lack of ST-segment elevation. Our findings also suggest that the identification of risk criteria may help to improve the recognition of ACI after OHCA.
Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
