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A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest

BACKGROUND: It has been recommended that all survivors of out-of-hospital cardiac arrest (OHCA) have immediate coronary angiography (CAG), even though it has been reported that half of the survivors have normal coronary arteries. Our aim was to develop a model which might identify those who have ang...

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Autores principales: Abe, Toshikazu, Watanabe, Shigeyuki, Mizuno, Atsushi, Toyama, Masahiro, Totten, Vicken Y., Tokuda, Yasuharu
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501276/
https://www.ncbi.nlm.nih.gov/pubmed/26175896
http://dx.doi.org/10.1186/s40560-015-0099-y
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author Abe, Toshikazu
Watanabe, Shigeyuki
Mizuno, Atsushi
Toyama, Masahiro
Totten, Vicken Y.
Tokuda, Yasuharu
author_facet Abe, Toshikazu
Watanabe, Shigeyuki
Mizuno, Atsushi
Toyama, Masahiro
Totten, Vicken Y.
Tokuda, Yasuharu
author_sort Abe, Toshikazu
collection PubMed
description BACKGROUND: It has been recommended that all survivors of out-of-hospital cardiac arrest (OHCA) have immediate coronary angiography (CAG), even though it has been reported that half of the survivors have normal coronary arteries. Our aim was to develop a model which might identify those who have angiographically normal coronary arteries. Reliable prediction would reduce unnecessary CAG. METHODS: A retrospective, observational, cohort study was conducted on 47 consecutive adult survivors who received immediate CAG after resuscitation from OHCA, between June 1, 2006 and March 31, 2011. We analyzed the clinical and electrocardiographic characteristics of the survivors with and without normal coronary arteries. RESULTS: All subjects had CAG. Normal coronary arteries were found in 25/47. These persons did not have diabetes mellitus (p = 0.0069) or a history of acute coronary syndrome (ACS) (p = 0.0069). Any abnormality of the ST segment or ST segment elevation on electrocardiogram (ECG) was strongly related to abnormal coronary arteries (p = 0.0045 and p = 0.0200, respectively). The partitioning model for predicting angiographically normal coronary arteries showed that all patients (8/8) with no ST segment change on their ECG had normal coronary arteries. Eight out of ten patients with ST segment abnormalities also had normal coronary arteries with a history of arrhythmia without a history of ACS. CONCLUSIONS: Survivors of OHCA who have no history of diabetes mellitus, who have no past history of ACS, and who present with no ST segment abnormalities may not require urgent/emergent CAG. Further studies are needed to guide clinicians in the determination of emergent cardiac catheterization following resuscitation of OHCA.
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spelling pubmed-45012762015-07-15 A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest Abe, Toshikazu Watanabe, Shigeyuki Mizuno, Atsushi Toyama, Masahiro Totten, Vicken Y. Tokuda, Yasuharu J Intensive Care Research Article BACKGROUND: It has been recommended that all survivors of out-of-hospital cardiac arrest (OHCA) have immediate coronary angiography (CAG), even though it has been reported that half of the survivors have normal coronary arteries. Our aim was to develop a model which might identify those who have angiographically normal coronary arteries. Reliable prediction would reduce unnecessary CAG. METHODS: A retrospective, observational, cohort study was conducted on 47 consecutive adult survivors who received immediate CAG after resuscitation from OHCA, between June 1, 2006 and March 31, 2011. We analyzed the clinical and electrocardiographic characteristics of the survivors with and without normal coronary arteries. RESULTS: All subjects had CAG. Normal coronary arteries were found in 25/47. These persons did not have diabetes mellitus (p = 0.0069) or a history of acute coronary syndrome (ACS) (p = 0.0069). Any abnormality of the ST segment or ST segment elevation on electrocardiogram (ECG) was strongly related to abnormal coronary arteries (p = 0.0045 and p = 0.0200, respectively). The partitioning model for predicting angiographically normal coronary arteries showed that all patients (8/8) with no ST segment change on their ECG had normal coronary arteries. Eight out of ten patients with ST segment abnormalities also had normal coronary arteries with a history of arrhythmia without a history of ACS. CONCLUSIONS: Survivors of OHCA who have no history of diabetes mellitus, who have no past history of ACS, and who present with no ST segment abnormalities may not require urgent/emergent CAG. Further studies are needed to guide clinicians in the determination of emergent cardiac catheterization following resuscitation of OHCA. BioMed Central 2015-07-15 /pmc/articles/PMC4501276/ /pubmed/26175896 http://dx.doi.org/10.1186/s40560-015-0099-y Text en © Abe et al. 2015 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Abe, Toshikazu
Watanabe, Shigeyuki
Mizuno, Atsushi
Toyama, Masahiro
Totten, Vicken Y.
Tokuda, Yasuharu
A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title_full A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title_fullStr A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title_full_unstemmed A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title_short A model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
title_sort model for predicting angiographically normal coronary arteries in survivors of out-of-hospital cardiac arrest
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4501276/
https://www.ncbi.nlm.nih.gov/pubmed/26175896
http://dx.doi.org/10.1186/s40560-015-0099-y
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