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Open Access Highly Accessed Research article

Routine angiography in survivors of out of hospital cardiac arrest with return of spontaneous circulation: a single site registry

Vishva A Wijesekera1*, Daniel V Mullany2, Catherina A Tjahjadi1 and Darren L Walters1

Author Affiliations

1 Heart Lung Institute, The Prince Charles Hospital, Brisbane, Australia

2 Department of Intensive Care, The Prince Charles Hospital, Brisbane, Australia

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BMC Cardiovascular Disorders 2014, 14:30  doi:10.1186/1471-2261-14-30

Published: 3 March 2014

Abstract

Background

Coronary revascularization in resuscitated out of hospital cardiac arrest (OOHCA) patients has been associated with improved survival.

Methods

This was a retrospective review of patients with OOHCA between 01/07/2007 and 31/03/2009 surviving to hospital admission. Cardiac risk factors, demographics, treatment times, electrocardiogram (ECG), angiographic findings and in-hospital outcomes were recorded.

Results

Of the 78 patients, 63 underwent coronary angiography. Traditional cardiac risk factors were common in this group. Chest pain occurred in 33.3% pre-arrest, 59.0% were initially treated at a peripheral hospital, 83.3% had documented ventricular tachycardia or ventricular fibrillation, 55.1% had specific ECG changes, 65.4% had acute myocardial infarction (AMI) as the cause of OOHCA and the majority had multi-vessel disease. ST elevation strongly predicted AMI. The in-hospital survival was 67.9% with neurological deficit in 13.2% of survivors. The group of patients who had an angiogram were more likely to have AMI as a cause of cardiac arrest (71.4% vs 40.0%, pā€‰=ā€‰0.01) and more likely to have survived to discharge (74.6% vs 40.0%, pā€‰<ā€‰0.01). Poor outcome was associated with older age, cardiogenic shock, longer transfer times, diabetes, renal impairment and a long duration to return of spontaneous circulation.

Conclusions

Acute myocardial infarction was the commonest cause of OOHCA and a high rate of survival to discharge was seen with a strategy of routine angiography and revascularization.

Keywords:
Cardiac arrest; Myocardial infarction; OOHCA; Angiography; Therapeutic hypothermia