Role of coronary angiography for out-of-hospital cardiac arrest survivors according to postreturn of spontaneous circulation on an electrocardiogram

被引:6
作者
Lee, Tae Rim [2 ]
Hwang, Sung Yeon [2 ]
Cha, Won Chul [1 ]
Shin, Tae Gun [1 ]
Sim, Min Seob [1 ]
Jo, Ik Joon [1 ]
Song, Keun Jeong [1 ]
Rhee, Joong Eui [1 ]
Jeong, Yeon Kwon [1 ]
机构
[1] Sungkyunkwan Univ, Sch Med, Dept Emergency Med, Samsung Med Ctr, Seoul, South Korea
[2] Kangwon Natl Univ, Emergency Med, Doctorial Course, Grad Sch, Chunchon, South Korea
关键词
acute myocardial infarction; cardiac arrest; coronary angiography; electrocardiogram; sudden cardiac death; EMERGENCY CARDIOVASCULAR CARE; AMERICAN-HEART-ASSOCIATION; ELEVATION MYOCARDIAL-INFARCTION; EUROPEAN RESUSCITATION COUNCIL; LONG-TERM PROGNOSIS; CARDIOPULMONARY-RESUSCITATION; VARIANT ANGINA; CLINICAL CHARACTERISTICS; CONSENSUS STATEMENT; ARTERY LESIONS;
D O I
10.1097/MD.0000000000006123
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Survivors of out-of-hospital cardiac arrest (OHCA) have high mortality and morbidity. An acute coronary event is the most common cause of sudden cardiac death. For this reason, coronary angiography is an important diagnostic and treatment strategy for patients with postcardiac arrest. This study aimed to identify the correlation between postreturn of spontaneous circulation (ROSC) on an electrocardiogram (ECG) and results of coronary angiography of OHCA survivors. We collected data from our OHCA registry from January 2010 to November 2014. We categorized OHCA survivors into 2 groups according to post-ROSC ECG results. Emergent coronary artery angiography (CAG) (CAG performed within 12hours after cardiac arrest) was performed in patients who showed ST segment elevation or new onset of left bundle branch block (LBBB) in post-ROSC ECG. For other patients, the decision for performing CAG was made according to agreement between the emergency physician and the cardiologist. During the study period, 472 OHCA victims visited our emergency department and underwent cardiopulmonary resuscitation. Among 198 OHCA survivors, 82 patients underwent coronary artery intervention. Thirty-one (70.4%) patients in the ST segment elevation or LBBB group and 10 (24.4%) patients in the nonspecific ECG group had coronary artery lesions (P<.01). Seven (18.4%) patients in the nonspecific ECG group showed coronary spasm. OHCA survivors without ST segment elevation or new onset LBBB still have significant coronary lesions in CAG. If there is no other obvious arrest cause in patients without significant changes in post ROSC ECG, CAG should be considered to rule out the possibility of coronary artery problems, including coronary spasm.
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页数:5
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