Routine angiography in survivors of out of hospital cardiac arrest with return of spontaneous circulation: a single site registry

BMC Cardiovascular Disorders

Research Article

Daniel V Mullany¹  Darren L Walters²  Vishva A Wijesekera²  Catherina A Tjahjadi² 

[1] Department of Intensive Care, The Prince Charles Hospital, Brisbane, Australia;Heart Lung Institute, The Prince Charles Hospital, Brisbane, Australia;

关键词: Cardiac arrest;    Myocardial infarction;    OOHCA;    Angiography;    Therapeutic hypothermia;   

DOI  :  10.1186/1471-2261-14-30

 received in 2013-07-14, accepted in 2014-02-24,  发布年份 2014

来源: Springer

【 摘 要 】

BackgroundCoronary revascularization in resuscitated out of hospital cardiac arrest (OOHCA) patients has been associated with improved survival.MethodsThis was a retrospective review of patients with OOHCA between 01/07/2007 and 31/03/2009 surviving to hospital admission. Cardiac risk factors, demographics, treatment times, electrocardiogram (ECG), angiographic findings and in-hospital outcomes were recorded.ResultsOf the 78 patients, 63 underwent coronary angiography. Traditional cardiac risk factors were common in this group. Chest pain occurred in 33.3% pre-arrest, 59.0% were initially treated at a peripheral hospital, 83.3% had documented ventricular tachycardia or ventricular fibrillation, 55.1% had specific ECG changes, 65.4% had acute myocardial infarction (AMI) as the cause of OOHCA and the majority had multi-vessel disease. ST elevation strongly predicted AMI. The in-hospital survival was 67.9% with neurological deficit in 13.2% of survivors. The group of patients who had an angiogram were more likely to have AMI as a cause of cardiac arrest (71.4% vs 40.0%, p = 0.01) and more likely to have survived to discharge (74.6% vs 40.0%, p < 0.01). Poor outcome was associated with older age, cardiogenic shock, longer transfer times, diabetes, renal impairment and a long duration to return of spontaneous circulation.ConclusionsAcute myocardial infarction was the commonest cause of OOHCA and a high rate of survival to discharge was seen with a strategy of routine angiography and revascularization.

【 授权许可】

CC BY   
© Wijesekera et al.; licensee BioMed Central Ltd. 2014