TY  - BOOK
AU  - Frohna, William J
AU  - Goyal, Munish
AU  - Wilson, Matthew
TI  - Incidence of coronary intervention in cardiac arrest survivors with non-shockable initial rhythms and no evidence of ST-elevation MI (STEMI)
SN  - 0300-9572
PY  - 2017///
KW  - *Cardiopulmonary Resuscitation
KW  - *Coronary Angiography
KW  - *Electric Countershock
KW  - *Myocardial Infarction
KW  - *Out-of-Hospital Cardiac Arrest
KW  - *Percutaneous Coronary Intervention
KW  - Cardiopulmonary Resuscitation/mt [Methods]
KW  - Cardiopulmonary Resuscitation/sn [Statistics & Numerical Data]
KW  - Coronary Angiography/mt [Methods]
KW  - Coronary Angiography/sn [Statistics & Numerical Data]
KW  - Electric Countershock/mt [Methods]
KW  - Electric Countershock/sn [Statistics & Numerical Data]
KW  - Emergency Medical Services/mt [Methods]
KW  - Emergency Medical Services/sn [Statistics & Numerical Data]
KW  - Female
KW  - Heart Rate
KW  - Humans
KW  - Incidence
KW  - Male
KW  - Middle Aged
KW  - Myocardial Infarction/di [Diagnosis]
KW  - Myocardial Infarction/ep [Epidemiology]
KW  - Out-of-Hospital Cardiac Arrest/ep [Epidemiology]
KW  - Out-of-Hospital Cardiac Arrest/th [Therapy]
KW  - Outcome and Process Assessment (Health Care)
KW  - Percutaneous Coronary Intervention/mt [Methods]
KW  - Percutaneous Coronary Intervention/sn [Statistics & Numerical Data]
KW  - Registries/sn [Statistics & Numerical Data]
KW  - United States/ep [Epidemiology]
KW  - MedStar Washington Hospital Center
KW  - Emergency Medicine
KW  - Journal Article
N2  - CONCLUSIONS: In this large multi-center retrospective analysis there is a high incidence of coronary intervention in post-arrest patients with initially non-shockable rhythms and without STEMI on ECG who are taken for angiography; Copyright (c) 2016. Published by Elsevier B.V; METHODS: Retrospective multicenter US clinical registry study of post-cardiac arrest patients at 18 hospitals between 1/00 and 5/14. The incidence of significant coronary artery disease (CAD) as defined by documented coronary intervention (i.e. PCI, angioplasty, stent or CABG) was assessed; OBJECTIVE: With the demonstrated benefit of an early-invasive strategy for STEMI and VF/VT arrest patients, there is interest in assessing the potential benefit of early angiography for non-shockable (PEA/Asystole) arrest patients. We hypothesized that in cardiac arrest patients who obtain return of spontaneous circulation (ROSC) after a non-shockable initial rhythm and do not have STEMI the incidence of coronary intervention would be clinically insignificant (<5%); RESULTS: There were 1396 arrest patients with ROSC and known initial rhythms (517/1396=37% shockable; 879/1396=63% nonshockable). 440 (299/440=58% shockable; 141/440=32% nonshockable) of these patients received angiography. In the 141 non-shockable patients that received angiography, 97 patients did not have STEMI listed as an indication for catheterization and 24 (25%) of those had a coronary intervention documented yielding an observed incidence of coronary intervention in non-shockable post-arrest patients without STEMI who received angiography of 24.7% (24/97). Of note, the overall incidence of coronary intervention in all ROSC patients with non-shockable initial rhythms was 5.5% (48/879)
UR  - https://dx.doi.org/10.1016/j.resuscitation.2016.10.025
ER  -