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Resuscitation ; 127: 21-25, 2018 06.
Artículo en Inglés | MEDLINE | ID: mdl-29549024

RESUMEN

AIM: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). METHODS: Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010-12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network. RESULTS: Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69-3.24) and for CAG plus PCI was 1.98 (95% CI 1.26-3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99-11.91) and for CAG plus PCI was 2.95 (95% CI 1.59-5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30-3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29-11.19). CONCLUSION: In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.


Asunto(s)
Reanimación Cardiopulmonar/métodos , Angiografía Coronaria , Paro Cardíaco Extrahospitalario/terapia , Anciano , Reanimación Cardiopulmonar/mortalidad , Reanimación Cardiopulmonar/estadística & datos numéricos , Angiografía Coronaria/estadística & datos numéricos , Femenino , Humanos , Masculino , Persona de Mediana Edad , Paro Cardíaco Extrahospitalario/mortalidad , Evaluación de Resultado en la Atención de Salud , Intervención Coronaria Percutánea/estadística & datos numéricos , Puntaje de Propensión , Estudios Prospectivos
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