Association between coronary angiography with or without percutaneous coronary intervention and outcomes after out-of-hospital cardiac arrest

Tyler F. Vadeboncoeur, Vatsal Chikani, Chengcheng Hu, Daniel W Spaite, Bentley J Bobrow

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Aim: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). Methods: Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010–12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network. Results: Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69–3.24) and for CAG plus PCI was 1.98 (95% CI 1.26–3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99–11.91) and for CAG plus PCI was 2.95 (95% CI 1.59–5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30–3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29–11.19). Conclusion: In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.

Original languageEnglish (US)
Pages (from-to)21-25
Number of pages5
JournalResuscitation
Volume127
DOIs
StatePublished - Jun 1 2018

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Out-of-Hospital Cardiac Arrest
Percutaneous Coronary Intervention
Coronary Angiography
Resuscitation
Observational Studies

Keywords

  • Cardiac arrest
  • Coronary angiography
  • Post-resuscitation care

ASJC Scopus subject areas

  • Emergency Medicine
  • Emergency
  • Cardiology and Cardiovascular Medicine

Cite this

@article{c8b648ff2e4b42c6b5970aa3c7ec4cff,
title = "Association between coronary angiography with or without percutaneous coronary intervention and outcomes after out-of-hospital cardiac arrest",
abstract = "Aim: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). Methods: Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010–12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network. Results: Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43{\%}) underwent CAG with resultant PCI in 157 (30{\%}). Survival in non-STE cases was: 56{\%} in cases without CAG; 82{\%} in cases with CAG but without PCI; and 78{\%} in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95{\%} CI 1.69–3.24) and for CAG plus PCI was 1.98 (95{\%} CI 1.26–3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95{\%} CI 3.99–11.91) and for CAG plus PCI was 2.95 (95{\%} CI 1.59–5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95{\%} CI 1.30–3.55) and for CPC 1/2 it was 5.06 (95{\%} CI 2.29–11.19). Conclusion: In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.",
keywords = "Cardiac arrest, Coronary angiography, Post-resuscitation care",
author = "Vadeboncoeur, {Tyler F.} and Vatsal Chikani and Chengcheng Hu and Spaite, {Daniel W} and Bobrow, {Bentley J}",
year = "2018",
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language = "English (US)",
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T1 - Association between coronary angiography with or without percutaneous coronary intervention and outcomes after out-of-hospital cardiac arrest

AU - Vadeboncoeur, Tyler F.

AU - Chikani, Vatsal

AU - Hu, Chengcheng

AU - Spaite, Daniel W

AU - Bobrow, Bentley J

PY - 2018/6/1

Y1 - 2018/6/1

N2 - Aim: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). Methods: Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010–12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network. Results: Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69–3.24) and for CAG plus PCI was 1.98 (95% CI 1.26–3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99–11.91) and for CAG plus PCI was 2.95 (95% CI 1.59–5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30–3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29–11.19). Conclusion: In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.

AB - Aim: The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE). Methods: Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010–12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network. Results: Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69–3.24) and for CAG plus PCI was 1.98 (95% CI 1.26–3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99–11.91) and for CAG plus PCI was 2.95 (95% CI 1.59–5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30–3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29–11.19). Conclusion: In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.

KW - Cardiac arrest

KW - Coronary angiography

KW - Post-resuscitation care

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U2 - 10.1016/j.resuscitation.2018.03.023

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