Acute cardiac care & resuscitation
Post-resuscitation ST-segment elevation and coronary angiographic phenotypes in angiography-evaluable survivors of out-of-hospital cardiac arrest with presumed coronary lesion-related arrest
Authors' conclusion
In this selected OHCA subset, post-resuscitation ST-segment elevation was associated with an acute occlusive coronary phenotype and greater myocardial injury, as in non-arrest acute coronary syndromes. However, the absence of ST-segment elevation did not exclude a coronary culprit lesion, so comprehensive coronary assessment is essential. ST-segment elevation was not independently associated with clinical outcomes after adjustment for pre-hospital factors. These findings should be interpreted considering substantial selection inherent to the study population.
Study context
- Population
- Successfully resuscitated out-of-hospital cardiac arrest (OHCA) patients admitted to our institution between January 2015 and December 2023, who underwent post-resuscitation coronary angiography and had presumed culprit lesionssuccessfully resuscitated OHCA patients who underwent post-resuscitation coronary angiography and had presumed culprit lesions
- Participants
- 149 participants
- Comparison
- Presence or absence of post-resuscitation ST-segment elevation
- Outcome
- Coronary phenotype and myocardial injury
Main finding
As reported in the abstract
- ST-segment elevation was associated with a more acute occlusive coronary phenotype, with more impaired culprit-vessel flow and greater myocardial injury
Further findings
Multivessel disease and chronic total occlusion
- Patients without ST-segment elevation more frequently had multivessel disease and chronic total occlusion, suggesting more complex coronary artery disease
Favorable neurological outcome
- Favorable neurological outcome was less frequent with ST-segment elevation in unadjusted analyses, but this association was not independent of pre-hospital factors
Original publication
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