Acute cardiac care & resuscitation
Coronary disease in refractory cardiac arrest undergoing resuscitation with extracorporeal membrane oxygenation
Authors' conclusion
Extracorporeal membrane oxygenation patients have more multivessel disease, ULM stenosis, and CTO but similar incidence, features, and distribution of acute culprit lesion. Despite more complex PCI, revascularization is less complete.
Study context
- Population
- Patients with cardiac arrest undergoing immediate coronary angiography, August 2013–August 2022matched cohort
- Participants
- 49 vs 49
- Exposure
- E-CPR vs ROSC after conventional cardiopulmonary resuscitation (C-CPR)
- E-CPRn = 49
- C-CPRn = 49reference
- Outcome
- Angiographic features: multivessel disease, ≥50% ULM stenosis, ≥1 CTO
Methodological detailsconsecutive patients
- Consecutive patients
Main finding
As reported in the abstract
| Group | Multivessel disease | ≥ 50% unprotected left main (ULM) stenosis | ≥1 chronic total occlusion (CTO) |
|---|---|---|---|
| E-CPR | 69.4% | 18.4% | 28.6% |
E-CPR
Multivessel disease69.4%
≥ 50% unprotected left main (ULM) stenosis18.4%
≥1 chronic total occlusion (CTO)28.6%
- E-CPR vs ROSC after C-CPR: P = 0.001 — multivessel disease: 69.4% vs. 34.7%
- E-CPR vs ROSC after C-CPR: P = 0.025 — ≥ 50% ULM stenosis: 18.4% vs. 4.1%
- E-CPR vs ROSC after C-CPR: P = 0.021 — ≥1 CTO: 28.6% vs. 10.2%
Observational data: associations, not effects.
Further findings
Final TIMI 3 flow and residual scores
Final TIMI 3 flow
P = 0.196
Residual SYNTAX E-CPR 13.6 · C-CPR 3.1 · P < 0.001
Residual GENSINI E-CPR 36.7 · C-CPR 10.9 · P < 0.001
| Outcome | E-CPR | C-CPR | P value |
|---|---|---|---|
| PCI: lesions treated and stents implanted per patient | |||
| Lesions treated | 1.3 lesions/patient | 1.1 lesions/patient | P = 0.002 |
| Stents implanted | 2.0/patient | 1.3/patient | P < 0.001 |
Score cut-offs predicting E-CPR
- SYNTAX cut-off 19.75
- sensitivity 74%, specificity 87%
- GENSINI cut-off 60.50
- sensitivity 69%, specificity 75%
Original publication
Coronary disease in refractory cardiac arrest undergoing resuscitation with extracorporeal membrane oxygenation. Eur Heart J Acute Cardiovasc Care. Published 21 February 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →