J Korean Soc Emerg Med.  2020 Apr;31(2):127-134.

Early coronary angiography in patients with out-of-hospital cardiac arrestand improved survival discharge rate

Affiliations
  • 1Department of Emergency Medicine, Keimyung University Dongsan Medical Center, Daegu, Korea

Abstract


Objective
Coronary angiography (CAG) is an important procedure in post-resuscitated patients with out of hospital cardiac arrest (OHCA). On the other hand, the timing of CAG is still controversial. This study investigated the relationship between electrocardiogram, cardiac enzyme, echocardiographic findings, and early coronary angiography (ECAG).
Methods
The medical records of OHCA patients from January 2014 to December 2018 were reviewed retrospectively. The total patients who underwent CAG for OHCA caused by cardiac origin were 48. They were divided into two groups according to survival discharge. The ECAG was defined as the time from reporting 119 to the CAG within two hours. The following items in the two groups were also analyzed: the prehospital factors, such as witnessed arrest, bystander cardiopulmonary resuscitation, shockable rhythm, and arrest to return of spontaneous circulation time; and the hospital factors, such as the timing of CAG, ST-segment elevation or depression in the electrocardiogram, troponin-I elevation, and transthoracic echocardiography findings.
Results
Twenty-seven patients out of 48 patients with OHCA (56.3%) underwent ECAG. In the survival group (n=35), ECAG incidence was significantly higher than the death group (n=24 [68.6%] vs. n=3 [23.1%], P=0.008) and the adjusted odds ratio of ECAG for predicting survival discharge was 10.69 (95% confidence interval, 1.7-68.8).
Conclusion
In this retrospective study, the patients applied with ECAG showed a better prognosis in the survival discharge rate than the patients with delayed CAG.

Keyword

Coronary angiography; Cardiac arrest; Electrocardiography
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