Three Factors Combined Predict Futility of Emergency Coronary Angiography After Out-of-Hospital Cardiac Arrest

Hirt, L; Kandan, Sri Raveen; Rahbi, Hazim; Khawaja, Muhammed Zeeshan; Mozid, Abdul; Dorman, Stephen; Johnson, Tom; Spratt, James C.; Strange, Julian

doi:10.1016/j.jacc.2018.07.039

Cited by 3 publications

(1 citation statement)

References 4 publications

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“…In cases of uncertainty (particularly for patients without STE), it may be useful to select patients according to their predicted neurological outcome using dedicated scores. Indeed, for those who are at high risk of mortality, it might be unwise to perform an early CAG as PCI in that case may be futile [44]. Recently developed prediction tools, such as severity scores, could represent a support to select categories or profiles of patients who may benefit from early CAG, with regards to the inherent limitations from these prediction models [45].…”

Section: Establishing Strategiesmentioning

confidence: 99%

Immediate postcardiac arrest treatment: coronary catherization or not?

Dumas

Bougouin

Cariou

2021

Current Opinion in Critical Care

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Purpose of reviewEarly coronary angiogram (CAG) remains a cornerstone in postcardiac arrest management as coronary disease (CAD)-related cardiac arrest is the leading cause of sudden death in adults. The opportunity to treat the cause early on with immediate CAG may improve outcome in cardiac arrest patients with AMI. Identifying the patients who will benefit from such an early invasive strategy is an unanswered question. Recent and ongoing trials may improve the level of evidence on this problematic, especially for some subgroup; however, current guidelines remain founded upon a very heterogeneous level of evidence. Recent findingsThe key variable to argue for immediate CAD remains the pattern of the ECG monitored after return of spontaneous of circulation (ROSC). ST-segment elevation (STE) on postresuscitation ECG is the strongest argument to rule for an early CAG strategy. In other situations, identifying the best candidates for early CAG is very challenging. Different approaches including elements, such as circumstances of cardiac arrest and expected outcomes. may also drive the strategy. SummaryThis review aims to provide an overview of these different discussion points. The indication for early CAG should rely on multiple factors and an individual approach.

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Section: Establishing Strategiesmentioning

confidence: 99%

Immediate postcardiac arrest treatment: coronary catherization or not?

Dumas

Bougouin

Cariou

2021

Current Opinion in Critical Care

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Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances

Carrick

Park

McGinnes

et al. 2020

JAHA

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Background More than 500 000 sudden cardiac arrests (SCAs) occur annually in the United States. Clinical predictive models (CPMs) may be helpful tools to differentiate between patients who are likely to survive or have good neurologic recovery and those who are not. However, which CPMs are most reliable for discriminating between outcomes in SCA is not known. Methods and Results We performed a systematic review of the literature using the Tufts PACE (Predictive Analytics and Comparative Effectiveness) CPM Registry through February 1, 2020, and identified 81 unique CPMs of SCA and 62 subsequent external validation studies. Initial cardiac rhythm, age, and duration of cardiopulmonary resuscitation were the 3 most commonly used predictive variables. Only 33 of the 81 novel SCA CPMs (41%) were validated at least once. Of 81 novel SCA CPMs, 56 (69%) and 61 of 62 validation studies (98%) reported discrimination, with median c‐statistics of 0.84 and 0.81, respectively. Calibration was reported in only 29 of 62 validation studies (41.9%). For those novel models that both reported discrimination and were validated (26 models), the median percentage change in discrimination was −1.6%. We identified 3 CPMs that had undergone at least 3 external validation studies: the out‐of‐hospital cardiac arrest score (9 validations; median c‐statistic, 0.79), the cardiac arrest hospital prognosis score (6 validations; median c‐statistic, 0.83), and the good outcome following attempted resuscitation score (6 validations; median c‐statistic, 0.76). Conclusions Although only a small number of SCA CPMs have been rigorously validated, the ones that have been demonstrate good discrimination.

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The unresolved problem of how to improve the prognosis of out of hospital cardiac arrest at place of residence

Peris

Lazzeri

2019

Minerva Anestesiol

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Three Factors Combined Predict Futility of Emergency Coronary Angiography After Out-of-Hospital Cardiac Arrest

Cited by 3 publications

References 4 publications

Immediate postcardiac arrest treatment: coronary catherization or not?

Immediate postcardiac arrest treatment: coronary catherization or not?

Clinical Predictive Models of Sudden Cardiac Arrest: A Survey of the Current Science and Analysis of Model Performances

The unresolved problem of how to improve the prognosis of out of hospital cardiac arrest at place of residence

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