Introduction: Little is known about discrepancies between patients who present with or without STEMI following out-of-hospital cardiac arrest (OHCA). Material and Methods: All patients with OHCA who were admitted to our hospital between January 1st 2008 and December 31st 2013 were classified according to their initial laboratory and electrocardiographic findings into STEMI, NSTEMI or no ACS. Results: Overall, 147 patients [32 STEMI (21.8%), 28 NSTEMI (19.0%) and 87 no ACS (59.2%)] were included with a mean age of 63.7 ± 13.3 years; there were 84 men (57.1%) and 63 (42.9%) women. Of these, 63 patients (51.7%) received coronary angiography [29 STEMI (90.6%), 9 NSTEMI (32.1%) and 38 no ACS (43.7%)] showing a high prevalence of coronary artery disease (CAD) [28 STEMI (96.6%), 9 NSTEMI (100.0%) and 26 no ACS (68.4%)] requiring percutaneous coronary intervention (PCI) in 52 cases [28 STEMI (96.6%), 8 NSTEMI (88.9%) and 16 no ACS (42.1%)]. Discussion: Coronary angiography immediately after hospital admission is feasible if all are prepared for potential further resuscitation efforts during cardiac catheterization. Primary focus on haemodynamic stabilisation may reduce the rates of coronary angiographies in patients following OHCA. Altogether, our data support the call for immediate coronary angiography in all patients following OHCA irrespective of their initial laboratory or electrocardiographic findings.
References
[1]
Nolan, J.P., Soar, J., Zideman, D.A., Biarent, D., Bossaert, L.L., Deakin, C., Koster, R.W., Wyllie, J. and Bottiger, B., ERC Guidelines Writing Group (2010) European Resuscitation Council Guidelines for Resuscitation 2010 Section 1. Executive Summary. Resuscitation, 81, 1219-1276. http://dx.doi.org/10.1016/j.resuscitation.2010.08.021
[2]
Pleskot, M., Hazukova, R., Stritecka, H., Cermakova, E. and Pudil, R. (2009) Long-Term Prognosis after Out-of-Hospital Cardiac Arrest with/without ST Elevation Myocardial Infarction. Resuscitation, 80, 795-804. http://dx.doi.org/10.1016/j.resuscitation.2009.04.004
[3]
Anyfantakis, Z.A., Baron, G., Aubry, P., Himbert, D., Feldman, L.J., Juliard, J.M., Ricard-Hibon, A., Burnod, A., Cokkinos, D.V. and Steg, P.G. (2009) Acute Coronary Angiographic Findings in Survivors of Out-of-Hospital Cardiac Arrest. American Heart Journal, 157, 312-318. http://dx.doi.org/10.1016/j.ahj.2008.09.016
[4]
Steg, P.G., James, S.K., Atar, D., Badano, L.P., Blomstrom-Lundqvist, C., Borger, M.A., Di Mario, C., Dickstein, K., Ducrocq, G., Fernandez-Aviles, F., Gershlick, A.H., Giannuzzi, P., Halvorsen, S., Huber, K., Juni, P., Kastrati, A., Knuuti, J., Lenzen, M.J., Mahaffey, K.W., Valgimigli, M., van’t Hof, A., Widimsky, P. and Zahger, D. (2012) ESC Guidelines for the Management of Acute Myocardial Infarction in Patients Presenting with ST-Segment Elevation: The Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). European Heart Journal, 33, 2569-2619.
[5]
Hamm, C.W., Bassand, J.P., Agewall, S., Bax, J., Boersma, E., Bueno, H., Caso, P., Dudek, D., Gielen, S., Huber, K., Ohman, M., Petrie, M.C., Sonntag, F., Uva, M.S., Storey, R.F., Wijns, W. and Zahger, D., ESC Committee for Practice Guidelines (2011) ESC Guidelines for the Management of Acute Coronary Syndromes in Patients Presenting without Persistent ST-Segment Elevation: The Task Force for the Management of Acute Coronary Syndromes (ACS) in Patients Presenting without Persistent ST-Segment Elevation of the European Society of Cardiology (ESC). European Heart Journal, 32, 2999-3054. http://dx.doi.org/10.1093/eurheartj/ehr236
[6]
Zimmermann, S., Flachskampf, F.A., Alff, A., Schneider, R., Dechant, K., Klinghammer, L., Stumpf, C., Zopf, Y., Loehr, T., Brand, G., Ludwig, J., Daniel, W.G. and Achenbach, S. (2013) Out-of-Hospital Cardiac Arrest and Percutaneous Coronary Intervention for ST-Elevation Myocardial Infarction: Long-Term Survival and Neurological Outcome. International Journal of Cardiology, 166, 236-241. http://dx.doi.org/10.1016/j.ijcard.2011.11.029
[7]
Sideris, G., Voicu, S., Yannopoulos, D., Dillinger, J.G,, Adjedj, J., Deye, N., Gueye, P., Manzo-Silberman, S., Malissin, I., Logeart, D., Magkoutis, N., Capan, D.D., Makhloufi, S., Megarbane, B., Vivien, B., Cohen-Solal, A., Payen, D., Baud, F.J. and Henry, P. (2014) Favourable 5-Year Post-Discharge Survival of Comatose Patients Resuscitated from Out- of-Hospital Cardiac Arrest, Managed with Immediate Coronary Angiogram on Admission. European Heart Journal: Acute Cardiovascular Care, 3, 183-191. http://dx.doi.org/10.1177/2048872614523348
[8]
Zanuttini, D., Armellini, I., Nucifora, G., Grillo, M.T., Morocutti, G., Carchietti, E., Trillò, G., Spedicato, L., Bernardi, G. and Proclemer, A. (2013) Predictive Value of Electrocardiogram in Diagnosing Acute Coronary Artery Lesions among Patients with Out-of-Hospital-Cardiac-Arrest. Resuscitation, 84, 1250-1254. http://dx.doi.org/10.1016/j.resuscitation.2013.04.023
[9]
Marcusohn, E., Roguin, A., Sebbag, A., Aronson, D., Dragu, R., Amikam, S., Boulus, M., Grenadier, E., Kerner, A., Nikolsky, E., Markiewicz, W., Hammerman, H. and Kapeliovich, M. (2007) Primary Percutaneous Coronary Intervention after Out-of-Hospital Cardiac Arrest: Patients and Outcomes. Israel Medical Association Journal, 9, 257-259.
[10]
Liu, H.W., Pan, W., Wang, L.F., Sun, Y.M., Li, Z.Q. and Wang, Z.H. (2012) Impact of Emergency Percutaneous Coronary Intervention on Outcomes of ST-Segment Elevation Myocardial Infarction Patients Complicated by Out-of-Hospital Cardiac Arrest. Chinese Medicine Journal (English), 125, 1405-1409.
[11]
Callaway, C.W., Schmicker, R.H., Brown, S.P., Albrich, J.M., Andrusiek, D.L., Aufderheide, T.P., Christenson, J., Daya, M.R., Falconer, D., Husa, R.D., Idris, A.H., Ornato, J.P., Rac, V.E., Rea, T.D., Rittenberger, J.C., Sears, G. and Stiell, I.G., ROC Investigators (2014) Early Coronary Angiography and Induced Hypothermia Are Associated with Survival and Functional Recovery after Out-of-Hospital Cardiac Arrest. Resuscitation, 85, 657-663. http://dx.doi.org/10.1016/j.resuscitation.2013.12.028
[12]
Hollenbeck, R.D., McPherson, J.A., Mooney, M.R., Unger, B.T., Patel, N.C., McMullan Jr., P.W., Hsu, C.H., Seder, D.B. and Kern, K.B. (2014) Early Cardiac Catheterisation Is Associated with Improved Survival in Comatose Survivors of Cardiac Arrest without STEMI. Resuscitation, 85, 88-95. http://dx.doi.org/10.1016/j.resuscitation.2013.07.027
[13]
Strote, J.A., Maynard, C., Olsufka, M., Nichol, G., Copass, M.K., Cobb, L.A. and Kim, F. (2012) Comparison of Role of Early (Less than Six Hours) to Later (More than Six Hours) or No Cardiac Catheterisation after Resuscitation from Out-of-Hospital Cardiac Arrest. The American Journal of Cardiology, 109, 451-454. http://dx.doi.org/10.1016/j.amjcard.2011.09.036
[14]
Aurore, A., Jabre, P., Liot, P., Margenet, A., Lecarpentier, E. and Combes, X. (2011) Predictive Factors for Positive Coronary Angiography in Out-of-Hospital Cardiac Arrest Patients. European Journal of Emergency Medicine, 18, 73-76. http://dx.doi.org/10.1097/MEJ.0b013e32833d469a
[15]
Bro-Jeppesen, J., Kjaergaard, J., Wanscher, M., Pedersen, F., Holmvang, L., Lippert, F.K., Moller, J.E., Kober, L. and Hassager, C. (2012) Emergency Coronary Angiography in Comatose Cardiac Arrest Patients: Do Real-Life Experiences Support the Guidelines? European Heart Journal: Acute Cardiovascular Care, 1, 291-301. http://dx.doi.org/10.1177/2048872612465588
[16]
Nanjayya, V.B. and Nayyar, V. (2012) Immediate Coronary Angiogram in Comatose Survivors of Out-of-Hospital Cardiac Arrest—An Australian Study. Resuscitation, 83, 699-704. http://dx.doi.org/10.1016/j.resuscitation.2011.12.004
[17]
Zanuttini, D., Armellini, I., Nucifora, G., Carchietti, E., Trillò, G., Spedicato, L., Bernardi, G. and Proclemer, A. (2012) Impact of Emergency Coronary Angiography on In-Hospital Outcome of Unconscious Survivors after Out-of-Hospital Cardiac Arrest. The American Journal of Cardiology, 110, 1723-1728. http://dx.doi.org/10.1016/j.amjcard.2012.08.006
[18]
Radsel, P., Knafelj, R., Kocjancic, S. and Noc, M. (2011) Angiographic Characteristics of Coronary Disease and Post-Resuscitation Electrocardiograms in Patients with Aborted Cardiac Arrest outside a Hospital. The American Journal of Cardiology, 108, 634-638. http://dx.doi.org/10.1016/j.amjcard.2011.04.008
[19]
Geri, G., Dumas, F. and Cariou, A. (2014) Should We Perform a Coronary Angiography in All Cardiac Arrest Survivors? Current Opinion in Critical Care, 20, 273-279.
http://dx.doi.org/10.1097/MCC.0000000000000093
[20]
Dumas, F., Manzo-Silberman, S., Fichet, J., Mami, Z., Zuber, B., Vivien, B., Chenevier-Gobeaux, C., Varenne, O., Empana, J.P., Pène, F., Spaulding, C. and Cariou, A. (2012) Can Early Cardiac Troponin I Measurement Help to Predict Recent Coronary Occlusion in Out-of-Hospital Cardiac Arrest Survivors? Critical Care Medicine, 40, 1777-1784. http://dx.doi.org/10.1097/CCM.0b013e3182474d5e
