Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction
| Autor: | Eva M Spoormans, Jorrit S Lemkes, Gladys N Janssens, Ouissal Soultana, Nina W van der Hoeven, Lucia S D Jewbali, Eric A Dubois, Martijn Meuwissen, Tom A Rijpstra, Hans A Bosker, Michiel J Blans, Gabe B Bleeker, Remon Baak, Georgios J Vlachojannis, Bob J W Eikemans, Pim van der Harst, Iwan C C van der Horst, Michiel Voskuil, Joris J van der Heijden, Albertus Beishuizen, Martin Stoel, Cyril Camaro, Hans van der Hoeven, José P Henriques, Alexander P J Vlaar, Maarten A Vink, Bas van den Bogaard, Ton A C M Heestermans, Wouter de Ruijter, Thijs S R Delnoij, Harry J G M Crijns, Pranobe V Oemrawsingh, Marcel T M Gosselink, Koos Plomp, Michael Magro, Paul W G Elbers, Peter M van de Ven, Niels van Royen |
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| Přispěvatelé: | Cardiology, ACS - Atherosclerosis & ischemic syndromes, Intensive Care Medicine, ACS - Microcirculation, ACS - Pulmonary hypertension & thrombosis, Graduate School, ACS - Heart failure & arrhythmias, General practice, Intensive care medicine, ACS - Diabetes & metabolism, Epidemiology and Data Science, MUMC+: MA Intensive Care (3), Intensive Care, MUMC+: MA Medische Staf IC (9), RS: Carim - V04 Surgical intervention, MUMC+: MA Cardiologie (9), Cardiologie, RS: Carim - H01 Clinical atrial fibrillation, Cardiovascular Centre (CVC), Critical care, Anesthesiology, Peri-operative and Emergency medicine (CAPE) |
| Jazyk: | angličtina |
| Rok vydání: | 2022 |
| Předmět: |
Coronary Angiography/methods
OUTCOMES PROGNOSIS Electrocardiography/methods ECG IMMEDIATE CORONARY-ANGIOGRAPHY Vascular damage Radboud Institute for Health Sciences [Radboudumc 16] Left ventricular function Vascular damage Radboud Institute for Molecular Life Sciences [Radboudumc 16] General Medicine POSTRESUSCITATION ELECTROCARDIOGRAMS Coronary Angiography Critical Care and Intensive Care Medicine Cardiac arrest Ischaemia Out-of-Hospital Cardiac Arrest/therapy Electrocardiography lnfectious Diseases and Global Health Radboud Institute for Health Sciences [Radboudumc 4] Troponin T Shockable rhythm Humans ST Elevation Myocardial Infarction Cardiology and Cardiovascular Medicine Out-of-Hospital Cardiac Arrest |
| Zdroj: | Spoormans, E M, Lemkes, J S, Janssens, G N, Soultana, O, van der Hoeven, N W, Jewbali, L S D, Dubois, E A, Meuwissen, M, Rijpstra, T A, Bosker, H A, Blans, M J, Bleeker, G B, Baak, R, Vlachojannis, G J, Eikemans, B J W, van der Harst, P, van der Horst, I C C, Voskuil, M, van der Heijden, J J, Beishuizen, A, Stoel, M, Camaro, C, van der Hoeven, H, Henriques, J P, Vlaar, A P J, Vink, M A, van den Bogaard, B, Heestermans, T A C M, de Ruijter, W, Delnoij, T S R, Crijns, H J G M, Oemrawsingh, P V, Gosselink, M T M, Plomp, K, Magro, M, Elbers, P W G, van de Ven, P M & van Royen, N 2022, ' Ischaemic electrocardiogram patterns and its association with survival in out-of-hospital cardiac arrest patients without ST-segment elevation myocardial infarction : a COACT trials' post-hoc subgroup analysis ', European heart journal. Acute cardiovascular care, vol. 11, no. 7, pp. 535-543 . https://doi.org/10.1093/ehjacc/zuac060 European Heart Journal Acute Cardiovascular Care, 11, 535-543 European heart journal. Acute cardiovascular care, 11(7), 535-543. SAGE Publications Ltd European Heart Journal: Acute Cardiovascular Care, 11(7), 535-543. SAGE Publications Ltd European Heart Journal: Acute Cardiovascular Care, 11(7), 535-543. SAGE Publications Inc. European Heart Journal Acute Cardiovascular Care, 11, 7, pp. 535-543 |
| ISSN: | 2048-8726 2048-8734 |
| DOI: | 10.1093/ehjacc/zuac060 |
| Popis: | Aims ST-depression and T-wave inversion are frequently present on the post-resuscitation electrocardiogram (ECG). However, the prognostic value of ischaemic ECG patterns is unknown. Methods and results In this post-hoc subgroup analysis of the Coronary Angiography after Cardiac arrest (COACT) trial, the first in-hospital post-resuscitation ECG in out-of-hospital cardiac arrest patients with a shockable rhythm was analysed for ischaemic ECG patterns. Ischaemia was defined as ST-depression of ≥0.1 mV, T-wave inversion in ≥2 contiguous leads, or both. The primary endpoint was 90-day survival. Secondary endpoints were rate of acute unstable lesions, levels of serum troponin-T, and left ventricular function. Of the 510 out-of-hospital cardiac arrest patients, 340 (66.7%) patients had ischaemic ECG patterns. Patients with ischaemic ECG patterns had a worse 90-day survival compared with those without [hazard ratio 1.51; 95% confidence interval (CI) 1.08–2.12; P = 0.02]. A higher sum of ST-depression was associated with lower survival (log-rank = 0.01). The rate of acute unstable lesions (14.5 vs. 15.8%; odds ratio 0.90; 95% CI 0.51–1.59) did not differ between the groups. In patients with ischaemic ECG patterns, maximum levels of serum troponin-T (μg/L) were higher [0.595 (interquartile range 0.243–1.430) vs. 0.359 (0.159–0.845); ratio of geometric means 1.58; 1.13–2.20] and left ventricular function (%) was worse (44.7 ± 12.5 vs. 49.9 ± 13.3; mean difference −5.13; 95% CI −8.84 to −1.42). Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival. Conclusion Post-arrest ischaemic ECG patterns were associated with worse 90-day survival. A higher sum of ST-depression was associated with lower survival. Adjusted for age and time to return of spontaneous circulation, ischaemic ECG patterns were no longer associated with survival. |
| Databáze: | OpenAIRE |
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