Performance of coronary angiography and intervention after out of hospital cardiac arrest.
Resuscitation
; 133: 141-146, 2018 12.
Article
em En
| MEDLINE
| ID: mdl-30316950
ABSTRACT
AIMS:
Out of Hospital Cardiac Arrest (OHCA) is frequently attributed to coronary artery disease, thus guidelines recommend coronary angiography (CAG) for survivors of OHCA. However, the real-world application of these guidelines is unknown, and we sought to evaluate CAG practices in the contemporary OHCA population.METHODS:
The Clinical Outcomes Assessment Program (COAP), a Washington State public reporting system, and the Cardiac Arrest Registry to Enhance Survival (CARES), a national registry of OHCA, were matched to characterize OHCA presentations between 2014 and 2015. Adults presenting to PCI-capable centers after OHCA were included. Logistic regression analyses were performed to assess predictors of undergoing CAG after OHCA.RESULTS:
2361 subjects were included with 729 (31%) proceeding to CAG, and 354 (15%) receiving PCI. The majority had return of spontaneous circulation (ROSC) at hospital arrival without identified ST elevations (72.2%). Of those with ST elevations and ROSC, 69% underwent CAG. OHCAs without ST elevations underwent CAG in 29.6% and PCI in 12.6%. After adjustment, older patients (aOR 0.73, 95% CI 0.72-0.84 per decade) and women (aOR 0.53, 95% CI 0.41-0.67) were less likely to proceed to CAG. Patients with witnessed arrest (aOR 2.07, 95% CI 1.62-2.67), VT/VF (aOR 6.11, 95% CI 4.85-7.69), ST elevations (aOR 3.82, 95% CI 2.71-5.38) and sustained ROSC (aOR 3.64, 95% CI 2.62-5.04) were more likely to undergo CAG.CONCLUSION:
Only one-third of patients presenting to PCI-capable hospitals underwent CAG after OHCA. Patient selection for an invasive strategy after OHCA appeared to be heavily influenced by pre-hospital presentation variables.Palavras-chave
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Angiografia Coronária
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Parada Cardíaca Extra-Hospitalar
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Intervenção Coronária Percutânea
Tipo de estudo:
Etiology_studies
/
Guideline
/
Incidence_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limite:
Aged
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Female
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Humans
/
Male
/
Middle aged
País/Região como assunto:
America do norte
Idioma:
En
Ano de publicação:
2018
Tipo de documento:
Article