059 Impact of immediate coronary angiography and new reanimation techniques in cardiac arrest patients

Autor: Olivier Barthelemy, Jean-Philippe Collet, Johanne Silvain, Charles-Edouard Luyt, Jean-Louis Trouillet, Antoine Landivier, Anne Bellemain-Appaix, Farzin Beygui, Gilles Montalescot, Thomas Chastre
Rok vydání: 2011
Předmět:
Zdroj: Archives of Cardiovascular Diseases Supplements. 3:19
ISSN: 1878-6480
Popis: Background Prognosis of patients surviving having an out-of-hospital or an in-hospital cardiac arrest is still very poor. Immediate coronary angiography with successful angioplasty has shown to improve prognosis of these patients. Nevertheless this strategy in the setting of new reanimation techniques using hypothermia or cardiac assistance has not yet been evaluated. Aim To evaluate the impact of coronarography and ad hoc angioplasty on survival rate. Methods The Pitie-Salpetriere registry included 328 consecutive patients who survived a cardiac arrest and were transferred to the cath-lab for emergency coronary angiography followed by ad-hoc PCI and state-of-the art critical care techniques. We present here intermediate results with the follow up of 223 consecutive patients. Results Most (65.7%) cardiac arrest survivors had angiographic coronary artery disease (at least one lesion >70%), with an attempted angioplasty in 49.1% of the total patients and in 75% of patients with coronary artery disease. Angioplasty was successful in 82.4% of attempted PCI. Total hospital survival rate was 43.8% when it was 45.7% in patients with CAD and 40.8% in patients without CAD, p = 0.1 with non adjusted HR 1.09 (95% CI 0.7–1.6). Survival rate was 48.3% in patients with successful PCI and 40.6% in patients without PCI or PCI failure, p = 0.3 with non adjusted HR 1.2(95% CI 0.8–1.8). Complete follow up pf the cohort is pending. Conclusions Two third of cardiac arrest survivors present with angiographic coronary artery disease and undergo 75% of attempted PCI. In this intermediate analysis presence of CAD and successful PCI provided trend in a better survival but were not significantly associated with a better outcomes. Download : Download full-size image
Databáze: OpenAIRE
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