Early prognosis and predictor analysis for positive coronary angiography after out-of-hospital cardiac arrest (OHCA)

Julien Higny, Antoine Guédès, Jacques Jamart, Claude Hanet, Laurence Gabriel, Vincent Dangoisse, Christophe de Meester de Ravenstein, Erwin Schroeder

Research output: Contribution to journalArticle

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 <.05). 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.

Original languageEnglish
Pages (from-to)535-542
Number of pages8
JournalActa Cardiologica
Volume73
Issue number6
DOIs
Publication statusPublished - 2 Nov 2018
Externally publishedYes

Keywords

  • acute coronary syndrome
  • coronary angiography
  • Out-of-hospital cardiac arrest
  • prognosis
  • resuscitation

Fingerprint Dive into the research topics of 'Early prognosis and predictor analysis for positive coronary angiography after out-of-hospital cardiac arrest (OHCA)'. Together they form a unique fingerprint.

  • Cite this