Cardiac arrest & resuscitation
Coronary features across the spectrum of out-of-hospital cardiac arrest with ST-elevation myocardial infarction (CAD-OHCA study)
Authors' conclusion
Compared to STEMI no OHCA, OHCA was associated with increased incidence of acute coronary occlusion and more complex non culprit CAD which progressively increased from conscious OHCA to E-CPR OHCA. Severity of CAD was associated with increased delays to ROSC/ECMO initiation and decreased long term survival.
Study context
- Population
- Adults with ST-elevation myocardial infarction (STEMI), with or without out-of-hospital cardiac arrest (OHCA), undergoing immediate coronary angiography, 2016–2022
- Participants
- 71 / 157 / 50 / 101
- Exposure
- OHCA with STEMI vs STEMI without OHCA
- Conscious OHCAn = 71
- Comatose OHCAn = 157
- E-CPR OHCAn = 50
- STEMI no OHCAn = 101reference
- Outcome
- CAD severity (SYNTAX score)
Methodological detailsconsecutive patients, blinded angiographic assessment, coronary artery disease (CAD) severity assessed by a single physician blinded to resuscitation method, time to reestablishment of spontaneous circulation (ROSC) and level of consciousness
- Consecutive patients
- Blinded angiographic assessment
- CAD severity assessed by a single physician blinded to resuscitation method, time to ROSC and level of consciousness
Main finding
As reported in the abstract
SYNTAX score
STEMI no OHCA
5.6
Conscious OHCA
10.2
Comatose OHCA
13.4
E-CPR OHCA
26.8
- Difference across groups
- P < 0.001
- Linear correlation of SYNTAX score with delay to ROSC/ECMO initiation (r2 = 0.61)
- P < 0.001
Observational data: associations, not effects.
Further findings
Survival · 5 years
| Outcome | Conscious OHCA | Comatose OHCA | E-CPR OHCA | STEMI no OHCA | P value |
|---|---|---|---|---|---|
| Acute culprit lesion, OHCA vs STEMI no OHCA | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 97% | P = 0.009 |
| Complete occlusion, OHCA vs STEMI no OHCA | — not stated in the abstract | — not stated in the abstract | — not stated in the abstract | 58.4% | P = 0.038 |
— not stated in the abstract
- Acute culprit lesion, OHCA vs STEMI no OHCA: OHCA 88.1%
- Complete occlusion, OHCA vs STEMI no OHCA: OHCA 68.8%
Post-PCI culprit TIMI 3 flow
- Comparable between the groups
- ≥86%
Survival · 5 years
- Significantly decreased in comatose and E-CPR OHCA vs conscious OHCA and STEMI no OHCA; SYNTAX score among independent predictors
Original publication
Coronary features across the spectrum of out-of-hospital cardiac arrest with ST-elevation myocardial infarction (CAD-OHCA study). Resuscitation. Published 30 September 2023. doi:10.
Composed by AI from the published abstract and checked against it. How Briefs are made →