The effect of immediate coronary angiography after cardiac arrest without ST-segment elevation on left ventricular function. A sub-study of the COACT randomised trial.

Autor: Lemkes JS; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands. Electronic address: j.lemkes@amsterdamumc.nl., Spoormans EM; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., Demirkiran A; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., Leutscher S; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., Janssens GN; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., van der Hoeven NW; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., Jewbali LSD; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands., Dubois EA; Department of Cardiology, Erasmus Medical Centre, Rotterdam, The Netherlands; Department of Intensive Care Medicine, Erasmus Medical Centre, Rotterdam, The Netherlands., Meuwissen M; Department of Cardiology, Amphia Hospital, Breda, The Netherlands., Rijpstra TA; Department of Intensive Care Medicine, Amphia Hospital, Breda, The Netherlands., Bosker HA; Department of Cardiology, Rijnstate Hospital, Arnhem, The Netherlands., Blans MJ; Department of Intensive Care Medicine, Rijnstate Hospital, Arnhem, The Netherlands., Bleeker GB; Department of Cardiology, HAGA Hospital, Den Haag, The Netherlands., Baak R; Department of Intensive Care Medicine, HAGA Hospital, Den Haag, The Netherlands., Vlachojannis GJ; Department of Cardiology, Maasstad Hospital, Rotterdam, The Netherlands; Department of Cardiology, University Medical Centre Utrecht, The Netherlands., Eikemans BJW; Department of Intensive Care Medicine, Maasstad Hospital, Rotterdam, The Netherlands., van der Harst P; University of Groningen, University Medical Centre Groningen, Department of Cardiology, Groningen, The Netherlands; Department of Cardiology, University Medical Centre Utrecht, The Netherlands., van der Horst ICC; University of Groningen, University Medical Centre Groningen, Department of Intensive Care Medicine, Groningen, The Netherlands; Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands., Voskuil M; Department of Cardiology, University Medical Centre Utrecht, The Netherlands., van der Heijden JJ; Department of Intensive Care Medicine, University Medical Centre Utrecht, The Netherlands., Beishuizen A; Department of Intensive Care Medicine, Medisch Spectrum Twente, Enschede, The Netherlands., Stoel M; Department of Cardiology, Medisch Spectrum Twente, Enschede, The Netherlands., Camaro C; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands., van der Hoeven H; Department of Intensive Care Medicine, Radboud University Medical Centre, Nijmegen, The Netherlands., Henriques JP; Department of Cardiology, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands., Vlaar APJ; Department of Intensive Care Medicine, Amsterdam University Medical Centre, Location AMC, Amsterdam, The Netherlands., Vink MA; Department of Cardiology, OLVG, Amsterdam, The Netherlands., van den Bogaard B; Department of Intensive Care Medicine, OLVG, Amsterdam, The Netherlands., Heestermans TACM; Department of Cardiology, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands., de Ruijter W; Department of Intensive care medicine, Noord West Ziekenhuisgroep, Alkmaar, The Netherlands., Delnoij TSR; Department of Intensive Care Medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, The Netherlands., Crijns HJGM; Department of Cardiology, Maastricht University Medical Centre, Maastricht, The Netherlands., Jessurun GAJ; Department of Cardiology, Scheper Hospital, Emmen, The Netherlands., Oemrawsingh PV; Department of Cardiology, Haaglanden Medical Centre, Den Haag, The Netherlands., Gosselink MTM; Department of Cardiology, Isala Hospital, Zwolle, The Netherlands., Plomp K; Department of Cardiology, Ter Gooi Hospital, Blaricum, The Netherlands., Magro M; Department of Cardiology, Elisabeth-Tweesteden Hospital, Tilburg, The Netherlands., Elbers PWG; Department of Intensive Care Medicine, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., van de Ven PM; Department of Epidemiology and Data Science, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., van Loon RB; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands., van Royen N; Department of Cardiology, Amsterdam University Medical Centre, Location VUmc, Amsterdam, The Netherlands; Department of Cardiology, Radboud University Medical Centre, Nijmegen, The Netherlands.
Jazyk: angličtina
Zdroj: Resuscitation [Resuscitation] 2021 Jul; Vol. 164, pp. 93-100. Date of Electronic Publication: 2021 Apr 28.
DOI: 10.1016/j.resuscitation.2021.04.020
Abstrakt: Background: The effect of immediate coronary angiography and percutaneous coronary intervention (PCI) in patients who are successfully resuscitated after cardiac arrest in the absence of ST-segment elevation myocardial infarction (STEMI) on left ventricular function is currently unknown.
Methods: This prespecified sub-study of a multicentre trial evaluated 552 patients, successfully resuscitated from out-of-hospital cardiac arrest without signs of STEMI. Patients were randomized to either undergo immediate coronary angiography or delayed coronary angiography, after neurologic recovery. All patients underwent PCI if indicated. The main outcomes of this analysis were left ventricular ejection fraction and end-diastolic and systolic volumes assessed by cardiac magnetic resonance imaging or echocardiography.
Results: Data on left ventricular function was available for 397 patients. The mean (± standard deviation) left ventricular ejection fraction was 45.2% (±12.8) in the immediate angiography group and 48.4% (±13.2) in the delayed angiography group (mean difference: -3.19; 95% confidence interval [CI], -6.75 to 0.37). Median left ventricular end-diastolic volume was 177 ml in the immediate angiography group compared to 169 ml in the delayed angiography group (ratio of geometric means: 1.06; 95% CI, 0.95-1.19). In addition, mean left ventricular end-systolic volume was 90 ml in the immediate angiography group compared to 78 ml in the delayed angiography group (ratio of geometric means: 1.13; 95% CI 0.97-1.32).
Conclusion: In patients successfully resuscitated after out-of-hospital cardiac arrest and without signs of STEMI, immediate coronary angiography was not found to improve left ventricular dimensions or function compared with a delayed angiography strategy.
Clinical Trial Registration: Netherlands Trial Register number, NTR4973.
Competing Interests: Declaration of Competing Interest The authors report no declarations of interest.
(Copyright © 2021 The Author(s). Published by Elsevier B.V. All rights reserved.)
Databáze: MEDLINE
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