Comparison of Role of Early (<6 Hours) to Later (>6 Hours) or No Cardiac Catheterization Following Resuscitation From Out-of-hospital Cardiac Arrest

• Published in: The American journal of cardiology 2011-11, Vol.109 (4), p.451-454
• Main Authors: Strote, Justin A., Maynard, Charles, Olsufka, Michele, Nichol, Graham, Copass, Michael K., Cobb, Leonard A., Kim, Francis
• Format: Article
• Language: English
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/j.amjcard.2011.09.036

Despite reports of patients with resuscitated sudden cardiac arrest (rSCA) receiving acute cardiac catheterization, the efficacy of this strategy is largely unknown. We hypothesized that acute cardiac catheterization of patients with rSCA would improve survival to hospital discharge. A retrospective cohort of 240 patients with out-of-hospital rSCA due to ventricular tachycardia or fibrillation was identified from 11 institutions in Seattle, Washington, between 1999 and 2002. Patients were grouped into those receiving acute catheterization within 6 hours (≤ 6 hours group, n = 61) and into those with deferred catheterization at > 6 hours or no catheterization during the index hospitalization (>6 hours group, n = 179). We directed attention to survival to hospital discharge, neurologic status, extent of coronary artery disease presenting electrocardiographic (ECG) findings, and pre-arrest symptoms. Propensity score methods were used to adjust for the likelihood of receiving acute catheterization. Survival was greater in patients who underwent acute catheterization ≤ 6 hours group (72%) vs. >6 hours group (49%) (p=0.001). Percutaneous coronary intervention was performed in 38/61 (62%) of patients in ≤ 6 hours group, and 13/170 (7%) in > 6 hours group, p