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Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms

AIM: To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic electrocardiogram. METHODS: From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnost...

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Autores principales: Martínez-Losas, Pedro, Salinas, Pablo, Ferrera, Carlos, Nogales-Romo, María Teresa, Noriega, Francisco, Del Trigo, María, Núñez-Gil, Iván Javier, Nombela-Franco, Luis, Gonzalo, Nieves, Jiménez-Quevedo, Pilar, Escaned, Javier, Fernández-Ortiz, Antonio, Macaya, Carlos, Viana-Tejedor, Ana
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Baishideng Publishing Group Inc 2017
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583543/
https://www.ncbi.nlm.nih.gov/pubmed/28932359
http://dx.doi.org/10.4330/wjc.v9.i8.702
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author Martínez-Losas, Pedro
Salinas, Pablo
Ferrera, Carlos
Nogales-Romo, María Teresa
Noriega, Francisco
Del Trigo, María
Núñez-Gil, Iván Javier
Nombela-Franco, Luis
Gonzalo, Nieves
Jiménez-Quevedo, Pilar
Escaned, Javier
Fernández-Ortiz, Antonio
Macaya, Carlos
Viana-Tejedor, Ana
author_facet Martínez-Losas, Pedro
Salinas, Pablo
Ferrera, Carlos
Nogales-Romo, María Teresa
Noriega, Francisco
Del Trigo, María
Núñez-Gil, Iván Javier
Nombela-Franco, Luis
Gonzalo, Nieves
Jiménez-Quevedo, Pilar
Escaned, Javier
Fernández-Ortiz, Antonio
Macaya, Carlos
Viana-Tejedor, Ana
author_sort Martínez-Losas, Pedro
collection PubMed
description AIM: To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic electrocardiogram. METHODS: From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnostic post-resuscitation electrocardiogram (defined as ST segment elevation or pre-sumably new left bundle branch block) who underwent invasive coronary angiogram during hospitalization were included. For purpose of analysis and comparison, patients were classified in two groups: Initial shockable rhythm (ventricular tachycardia or ventricular fibrillation; n = 148, 72.9%) and initial non-shockable rhythm (n = 55, 27.1%). Baseline characteristics, coronary angiogram findings including Syntax Score and long-term survival rates were compared. RESULTS: Sudden cardiac arrest was witnessed in 95.2% of cases, 66.7% were out-of-hospital patients and 72.4% were male. There were no significant differences in baseline characteristics between groups except for higher mean age (68.1 years vs 61 years, P = 0.001) in the non-shockable rhythm group. Overall 5-year mortality of the resuscitated patients was 37.4%. Patients with non-shockable rhythms had higher mortality (60% vs 29.1%, P < 0.001) and a worst neurological status at hospital discharge based on cerebral performance category score (CPC 1-2: 32.7% vs 53.4%, P = 0.02). Although there were no significant differences in global burden of coronary artery disease defined by Syntax Score (mean Syntax Score: 10.2 vs 10.3, P = 0.96) there was a trend towards a higher incidence of acute coronary lesions in patients with shockable rhythm (29.7% vs 16.4%, P = 0.054). There was also a higher need for ad-hoc percutaneous coronary intervention in this group (21.9% vs 9.1%, P = 0.03). CONCLUSION: Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs non-shockable group.
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spelling pubmed-55835432017-09-20 Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms Martínez-Losas, Pedro Salinas, Pablo Ferrera, Carlos Nogales-Romo, María Teresa Noriega, Francisco Del Trigo, María Núñez-Gil, Iván Javier Nombela-Franco, Luis Gonzalo, Nieves Jiménez-Quevedo, Pilar Escaned, Javier Fernández-Ortiz, Antonio Macaya, Carlos Viana-Tejedor, Ana World J Cardiol Observational Study AIM: To investigate the impact of coronary artery disease in a cohort of patients resuscitated from cardiac arrest with non-diagnostic electrocardiogram. METHODS: From March 2004 to February 2016, 203 consecutive patients resuscitated from in or out-of-hospital sudden cardiac arrest and non-diagnostic post-resuscitation electrocardiogram (defined as ST segment elevation or pre-sumably new left bundle branch block) who underwent invasive coronary angiogram during hospitalization were included. For purpose of analysis and comparison, patients were classified in two groups: Initial shockable rhythm (ventricular tachycardia or ventricular fibrillation; n = 148, 72.9%) and initial non-shockable rhythm (n = 55, 27.1%). Baseline characteristics, coronary angiogram findings including Syntax Score and long-term survival rates were compared. RESULTS: Sudden cardiac arrest was witnessed in 95.2% of cases, 66.7% were out-of-hospital patients and 72.4% were male. There were no significant differences in baseline characteristics between groups except for higher mean age (68.1 years vs 61 years, P = 0.001) in the non-shockable rhythm group. Overall 5-year mortality of the resuscitated patients was 37.4%. Patients with non-shockable rhythms had higher mortality (60% vs 29.1%, P < 0.001) and a worst neurological status at hospital discharge based on cerebral performance category score (CPC 1-2: 32.7% vs 53.4%, P = 0.02). Although there were no significant differences in global burden of coronary artery disease defined by Syntax Score (mean Syntax Score: 10.2 vs 10.3, P = 0.96) there was a trend towards a higher incidence of acute coronary lesions in patients with shockable rhythm (29.7% vs 16.4%, P = 0.054). There was also a higher need for ad-hoc percutaneous coronary intervention in this group (21.9% vs 9.1%, P = 0.03). CONCLUSION: Initial shockable group of patients had a trend towards higher incidence of acute coronary lesions and higher need of ad-hoc percutaneous intervention vs non-shockable group. Baishideng Publishing Group Inc 2017-08-26 2017-08-26 /pmc/articles/PMC5583543/ /pubmed/28932359 http://dx.doi.org/10.4330/wjc.v9.i8.702 Text en ©The Author(s) 2017. Published by Baishideng Publishing Group Inc. All rights reserved. http://creativecommons.org/licenses/by-nc/4.0/ Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
spellingShingle Observational Study
Martínez-Losas, Pedro
Salinas, Pablo
Ferrera, Carlos
Nogales-Romo, María Teresa
Noriega, Francisco
Del Trigo, María
Núñez-Gil, Iván Javier
Nombela-Franco, Luis
Gonzalo, Nieves
Jiménez-Quevedo, Pilar
Escaned, Javier
Fernández-Ortiz, Antonio
Macaya, Carlos
Viana-Tejedor, Ana
Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title_full Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title_fullStr Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title_full_unstemmed Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title_short Coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: A comparison of shockable and non-shockable initial rhythms
title_sort coronary angiography findings in cardiac arrest patients with non-diagnostic post-resuscitation electrocardiogram: a comparison of shockable and non-shockable initial rhythms
topic Observational Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583543/
https://www.ncbi.nlm.nih.gov/pubmed/28932359
http://dx.doi.org/10.4330/wjc.v9.i8.702
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