ABSTRACT
BACKGROUND
There is broad consensus that resuscitated out-of-hospital cardiac arrest (OHCA) patients
with ST-segment elevation myocardial infarction (STEMI) should receive immediate coronary
angiography (CAG); however, factors that guide patient selection and optimal timing
of CAG for post-arrest patients without evidence of STEMI remain incompletely described.
OBJECTIVES
We sought to describe the timing of post-arrest CAG in actual practice, patient characteristics
associated with decision to perform immediate versus delayed CAG, and patient outcomes
following CAG.
METHODS
We conducted a retrospective cohort study at seven U.S. academic hospitals. Resuscitated
adult OHCA patients were included if they presented between 1/1/2015-12/31/2019 and
recieved CAG during hospitalization. EMS run-sheets and hospital records were analyzed.
Patients without evidence of STEMI were grouped and compared based on time from arrival
to CAG performance into “early” (≤6 hours) and “delayed” (>6 hours).
RESULTS
221 patients were included. Median time to CAG was 18.6 (IQR:1.5-94.6) hours. Early
catheterization was performed on 94 patients (42.5%) and delayed catheterization on
127 patients (57.5%). Patients in the early group were older (61 [IQR:55-70] vs. 57
[IQR:47-65] years) and more likely to be male (79.8%vs.59.8%). Those in the early
group were more likely to have clinically significant lesions (58.5%vs.39.4%) and
receive revascularization (41.5%vs.19.7%). Patients were more likely to die in the
early group (47.9%vs.33.1%). Among survivors, there was no significant difference
in neurologic recovery at discharge.
CONCLUSIONS
OHCA patients without evidence of STEMI who received early CAG were older and more
likely to be male. This group was more likely to have intervenable lesions and receive
revascularization.
Keywords
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Article info
Publication history
Accepted:
January 6,
2023
Received in revised form:
December 18,
2022
Received:
September 6,
2022
Publication stage
In Press Accepted ManuscriptIdentification
Copyright
© 2023 Elsevier Inc. All rights reserved.
