Impact of early coronary angiography on the survival to discharge after out-of-hospital cardiac arrest

• Published in: Clinical and experimental emergency medicine 2017, 4(2), , pp.65-72
• Main Authors: Shin, Jikyoung, Ko, Eunsil, Cha, Won Chul, Lee, Tae Rim, Yoon, Hee, Hwang, Sung Yeon, Shin, Tae Gun, Sim, Min Seob, Jo, Ik Joon, Song, Keun Jeong, Rhee, Joong Eui, Jeong, Yeon Kwon, Choi, Jin-Ho
• Format: Article
• Language: English
• Subjects: early coronary angiography; neurologic outcome; Original; out-of-hospital cardiac arrest; survival rate; 응급의학
• ISSN: 2383-4625; 2383-4625
• DOI: 10.15441/ceem.16.167

Acute myocardial infarction is a major cause of out-of-hospital cardiac arrest (OHCA). Coronary angiography (CAG) enables diagnostic confirmation of coronary artery disease and subsequent revascularization, which might improve the prognosis of OHCA survivors. Non-randomized data has shown a favorable impact of CAG on prognosis for this population. However, the optimal timing of CAG has been debated. The clinical outcomes of 607 OHCA patients registered in CAPTURES (Cardiac Arrest Pursuit Trial with Unique Registration and Epidemiologic Surveillance), a nationwide multicenter registry performed in 27 hospitals, were analyzed. Early CAG was defined as CAG performed within 24 hours of emergency department admission. The primary outcome was survival to discharge, with neurologically favorable status defined by cerebral performance category scores ≤2. Compared to patients without CAG (n=469), patients who underwent early CAG (n=138) were younger, more likely to be male, and more likely to have received bystander cardiopulmonary resuscitation, pre-hospital defibrillation, and revascularization (P