UMEM Educational Pearls

 

Acute coronary thrombotic occlusion is the most common trigger of cardiac arrest
The benefit of coronary angiography  seems to be well established in patients who regain consciousness soon after recovery of spontaneous circulation
Whether emergency coronary angiography and PCI improve survival in patients who remain unconscious after ROSC remains unknown
Results of this study can be summarized as follows:
       1. CAD and acute or recent culprit coronary lesions are present in most resuscitated unconscious  patients with OHCA without obvious extracardiac cause
       2. CAD and acute or recent culprit coronary lesions are observed in most patients with ST-segment elevation and in a non-negligible proportion of patients with other ECG patterns on post-ROSC electrocardiograph
       3. Emergency coronary angiography and successful emergency PCI are independently related to in-hospital survival after OHCA

References

Zanuttini D,  Armellini I, et al. Impact of Emergency Coronary Angiography on In-Hospital Outcome of Unconscious Survivors After Out-of-Hospital Cardiac Arrest Original. J Am Coll Cardiol 2012; 110:12 pages 1723-1728