Early cardiac catheterization is associated with improved survival in comatose survivors of cardiac arrest without STEMI

Hollenbeck, Ryan D.; McPherson, John; Mooney, M.; Unger, RN Barbara; Patel, Nainesh C; McMullan, Paul W.; Hsu, Chiu‐Hsieh; Seder, David B.; Kern, Karl B.

doi:10.1016/j.resuscitation.2013.07.027

Cited by 206 publications

(159 citation statements)

References 23 publications

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“…In fact, impact of PCI was comparable in both STEMI and NSTEMI subgroups. These findings were consistent with previous literature [28,29]. Another important aspect of the study was PCI utilization trend.…”

Section: Discussionsupporting

confidence: 93%

Impact of Percutaneous Coronary Intervention on in Hospital Mortality in Cardiac Arrest – A National Perspective

Tripathi¹,

Arora²,

Panaich³

et al. 2016

Angiol

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Section: Discussionsupporting

confidence: 93%

Impact of Percutaneous Coronary Intervention on in Hospital Mortality in Cardiac Arrest – A National Perspective

Tripathi¹,

Arora²,

Panaich³

et al. 2016

Angiol

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“…The issue is further complicated by difficulties interpreting symptoms as well as the ECG in the post cardiac arrest setting since the post resuscitation ECG seem to be a poor predictor of an acute coronary occlusion [8,9]. No randomized trials have evaluated the potential benefit of immediate coronary angiography in patients without STEMI and register studies have shown diverging results [10][11][12]. A recent sub study of the Targeted Temperature Management (TTM) trial revealed no survival benefit of coronary angiography within 6 hours of cardiac arrest among patients without STEMI at presentation [13].…”

Section: Introductionmentioning

confidence: 99%

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

et al. 2016

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High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest -A targeted temperature management (TTM) trial substudyGilje, Patrik; Koul, Sasha; Thomsen, Jakob Hartvig; Devaux, Yvan; Friberg, Hans; Kuiper, Michael; Horn, Janneke; Nielsen, Niklas; Pellis, Tomasso; Stammet, Pascal; Wise, Matthew P.; Kjaergaard, Jesper; Hassager, Christian; Erlinge, David Link to publication Citation for published version (APA): Gilje, P., Koul, S., Thomsen, J. H., Devaux, Y., Friberg, H., Kuiper, M., ... Erlinge, D. (2016). High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest -A targeted temperature management (TTM) trial substudy. Resuscitation, 107, 156-161. DOI: 10.1016/j.resuscitation.2016 General rights Copyright and moral rights for the publications made accessible in the public portal are retained by the authors and/or other copyright owners and it is a condition of accessing publications that users recognise and abide by the legal requirements associated with these rights.• Users may download and print one copy of any publication from the public portal for the purpose of private study or research.• You may not further distribute the material or use it for any profit-making activity or commercial gain • You may freely distribute the URL identifying the publication in the public portal Predicting outcome of unconscious patients after successful resuscitation is challenging and better prognostic markers are highly needed. Ischemic heart disease is a common cause of out-of-hospital cardiac arrest (OHCA).Whether or not high-sensitivity troponin T (hs-TnT) is a prognostic marker among survivors of OHCA with both ischemic and non-ischemic aetiologies remains to be determined. We sought to evaluate the ability of hs-TnT to prognosticate all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes after OHCA. The influence of the level of target temperature management on hs-TnT as a marker of infarct size was also assessed. Methods:A total of 699 patients from the Targeted Temperature Management (TTM) trial were included and hs-TnT was analysed in blood samples from 24, 48 and 72 h after return of spontaneous circulation (ROSC). The endpoints were 180 day all-cause mortality, death due to cardiovascular causes or multi-organ failure and death due to cerebral causes. Subgroups based on the initial ECG after ROSC (STEMI vs all other ECG presentations) were analysed. Results:Hs-TnT was independently associated with all-cause mortality which was driven by death due to cardiovascular causes or multi-organ failure and not cerebral causes (at 48h: OR 1.10, CI 1.01-1.20, p<0.05). Hs-TnT was also an independent predictor of death due to cardiovascular causes or multi-organ failure (at 48h: OR 1.13, CI 1.01-1.26, p<0.05). In patients with STEMI, hs-TnT was independently associated with death due to cardiovascular causes or multi-organ failure (at 48h: OR 1.47, CI 1.10-1.95, p<0.01). Targeted temperature management at 33 °C was not ...

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“…Several studies have identified in-hospital factors associated with improved mortality after successful resuscitation from OHCA in patients ad- (36,37) or with no ST elevation on ECG. (38,39) The benefit of ECMO on survival and neurological function in a selected patient group following OHCA had also been documented. (9,10) Though there was a relatively small number of major interventions in our study, patients with TTM, or coronary artery angiography, or ECMO had higher hospital survival, in agreement with the results of many reports.…”

Section: Discussionmentioning

confidence: 99%

Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey

Chen

Hung²,

Chang³

et al. 2017

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Background. The overall survival rate of out-of-hospital cardiac arrest (OHCA) in Taiwan or even in the whole of Asia is relatively low. Major interventions, such as target temperature management (TTM), coronary artery angiography, and extracorporeal membrane oxygenation (ECMO), have been associated with better patient outcome. However, studies in Taiwan revealing evidence of the benefits of these interventions are limited. Methods. A population-based study used an 8-year database to analyze overall survival and risk factors ˝among OHCA patients. All adult non-trauma OHCA patients were identified through diagnostic and procedure codes. Hospital survival and return of spontaneous circulation (ROSC) were primary and secondary outcomes. Logistic regression and Cox regression analyses were conducted. Results. There was a relationship between major interventions (including TTM, coronary artery angiography, and ECMO) and better hospital survival. Age, income, major interventions, and acute myocardial infarction history were associated with hospital survival. The adjusted hazard ratios (HRs) were 0.406 (95% CI, 0.295 to 0.558), 1.109 (95% CI, 1.027 to 1.197), 1.075 (95% CI, 1.002 to 1.154), 1.097 (95% CI, 1.02 to 1.181) and 0.799(95% CI, 0.677 to 0.942) for patients with major interven-

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Early cardiac catheterization is associated with improved survival in comatose survivors of cardiac arrest without STEMI

Cited by 206 publications

References 23 publications

Impact of Percutaneous Coronary Intervention on in Hospital Mortality in Cardiac Arrest – A National Perspective

Impact of Percutaneous Coronary Intervention on in Hospital Mortality in Cardiac Arrest – A National Perspective

High-sensitivity troponin-T as a prognostic marker after out-of-hospital cardiac arrest – A targeted temperature management (TTM) trial substudy

Major interventions are associated with survival of out of hospital cardiac arrest patients - a population based survey

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