Should We Perform an Immediate Coronary Angiogram in All Patients After Cardiac Arrest?
| Autor: | Wulfran Bougouin, Florence Dumas, Nicole Karam, Carole Maupain, Eloi Marijon, Lionel Lamhaut, Daniel Jost, Guillaume Geri, Frankie Beganton, Olivier Varenne, Christian Spaulding, Xavier Jouven, Alain Cariou, F. Adnet, J.M. Agostinucci, N. Aissaoui-Balanant, J. Albuisson, V. Algalarrondo, F. Alla, D. Annane, C. Antoine, P. Aubry, E. Azoulay, F. Beganton, D. Benhamou, W. Bougouin, C. Bruel, A. Cariou, P. Carli, C. Cerf, A. Chaib, J. Chastre, Y. Cohen, A. Combes, C. Cornaglia, D. Da Silva, V. Das, A. Demoule, N. Deye, G. Dhonneur, J.L. Diehl, S. Dinanian, L. Domanski, D. Dreyfuss, D. Duboc, J.L. Dubois-Rande, O. Dubourg, F.X. Duchateau, F. Dumas, J.P. Empana, F. Extramiana, J.Y. Fagon, M. Fartoukh, C. Fenioux, F. Fieux, F. Fraisse, M. Gabbas, E. Gandjbakhch, B. Guidet, P. Henry, F. Hidden Lucet, P. Jabre, L. Jacob, L. Joseph, D. Jost, D. Journois, X. Jouven, N. Karam, H. Kassim, K. Lahlou-Laforet, L. Lamhaut, A. Lanceleur, O. Langeron, V. Lanoe, E. Lecarpentier, A. Leenhardt, N. Lellouche, V. Lemiale, F. Linval, T. Loeb, B. Ludes, A. Maltret, N. Mansouri, J. Mantz, E. Marijon, J. Marty, E. Maury, V. Maxime, A. Mekontso-Dessaps, J.P. Mira, X. Monnet, M.C. Perier, O. Piot, R. Pirraccchio, I. Plu, M. Raux, F. Revaux, J.D. Ricard, C. Richard, B. Riou, F. Roussin, F. Santoli, F. Schortgen, T. Sharshar, G. Sideris, C. Spaulding, J.L. Teboul, J.F. Timsit, J.P. Tourtier, P. Tuppin, C. Ursat, O. Varenne, A. Vieillard-Baron, S. Voicu, K. Wahbi |
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| Rok vydání: | 2018 |
| Předmět: |
medicine.medical_specialty
business.industry medicine.medical_treatment Basic life support Percutaneous coronary intervention 030208 emergency & critical care medicine 030204 cardiovascular system & hematology Return of spontaneous circulation Coronary angiogram Logistic regression Sudden death 03 medical and health sciences 0302 clinical medicine Epinephrine Internal medicine medicine Cardiology Hospital discharge Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | JACC: Cardiovascular Interventions. 11:249-256 |
| ISSN: | 1936-8798 |
| Popis: | Objectives This study sought to assess the relationship between an immediate invasive strategy and survival after an out-of-hospital cardiac arrest (OHCA) of presumed cardiac cause, according to prognosis evaluated on hospital arrival. Background An immediate coronary angiogram (CAG) may be associated with better outcome after OHCA in neurologically preserved patients but could be futile in other cases. Methods From May 2011 to May 2015, we collected data for all patients admitted in hospital after OHCA in Paris and its suburbs (France). Risk of in-hospital death was retrospectively calculated using the validated Cardiac Arrest Hospital Prognosis score, which includes age, setting, initial rhythm, durations from collapse to basic life support and from basic life support to return of spontaneous circulation, pH, and epinephrine dose. Independent predictors of survival at discharge (including immediate CAG) were assessed in multivariate logistic regression in each of the 3 pre-defined subgroups of Cardiac Arrest Hospital Prognosis score: low risk ( 200 points) for in-hospital death. Results A total of 1,410 patients were included and overall survival rate at hospital discharge was 32%. Distribution in the low-, medium-, and high-risk Cardiac Arrest Hospital Prognosis subgroups was 667 (47%), 469 (33%), and 274 patients (20%), respectively. The rate of early CAG was 86%, 66%, and 47% in the low-, medium-, and high-risk subgroups, respectively (p Conclusions In cardiac arrest patients, our results suggest that investigations regarding early CAG after OHCA should focus on patients with preserved neurological status. |
| Databáze: | OpenAIRE |
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