The role of coronary angiography in out-of-hospital cardiac arrest patients in the absence of ST-segment elevation: A literature review

Out-of-hospital cardiac arrest (OHCA) is a major cause of death. Although the aetiology of cardiac arrest can be diverse, the most common cause is ischaemic heart disease. Coronary angiography and percutaneous coronary intervention, if indicated, has been associated with improved long-term survival...

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Bibliographic Details
Published in:Netherlands heart journal 2020-08, Vol.28 (Suppl 1), p.108-114
Main Authors: Spoormans, E. M., Lemkes, J. S., Janssens, G. N., van der Hoeven, N. W., Bonnes, J. L., van Royen, N.
Format: Article
Language:English
Subjects:
Acute coronary syndromes
Angioplasty
Cardiac arrest
Cardiac arrhythmia
Cardiology
Cardiovascular disease
Cohort analysis
Coronary vessels
Electrocardiography
Heart attacks
Intensive care
Ischemia
Literature reviews
Medical Education
Medical imaging
Medicine
Medicine & Public Health
Mortality
Observational studies
Patients
Review Article
Rhythm
Vein & artery diseases
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Summary:Out-of-hospital cardiac arrest (OHCA) is a major cause of death. Although the aetiology of cardiac arrest can be diverse, the most common cause is ischaemic heart disease. Coronary angiography and percutaneous coronary intervention, if indicated, has been associated with improved long-term survival for patients with initial shockable rhythm. However, in patients without ST-segment elevation on the post-resuscitation electrocardiogram, the optimal timing of performing this invasive procedure is uncertain. One important challenge that clinicians face is to appropriately select patients that will benefit from immediate coronary angiography, yet avoid unnecessary delay of intensive care support and targeted temperature management. Observational studies have reported contradictory results and until recently, randomised trials were lacking. The Coronary Angiography after Cardiac Arrest without ST-segment elevation (COACT) was the first randomised trial that provided comparative information between coronary angiography treatment strategies. This literature review will provide the current knowledge and gaps in the literature regarding optimal care for patients successfully resuscitated from OHCA in the absence of ST-segment elevation and will primarily focus on the role and timing of coronary angiography in this high-risk patient population.
ISSN:1568-5888
1876-6250
DOI:10.1007/s12471-020-01460-8