The aim of our study was to assess the impact of coronary angiography (CAG) after out-of-hospital cardiac arrest (OHCA) without ST-elevation (STE).
Prospective observational study of adult (age ≥ 18) OHCA of presumed cardiac etiology from 1/01/2010–12/31/2014 admitted to one of 40 recognized cardiac receiving centers within a statewide resuscitation network.
Among 11,976 cases, 1881 remained for analysis after exclusions. Of the 1230 non-STE cases, 524 (43%) underwent CAG with resultant PCI in 157 (30%). Survival in non-STE cases was: 56% in cases without CAG; 82% in cases with CAG but without PCI; and 78% in those with PCI (p < 0.0001). In cases without STE the aOR for survival with CAG alone was 2.34 (95% CI 1.69–3.24) and for CAG plus PCI was 1.98 (95% CI 1.26–3.09). The aOR for CPC 1/2 with CAG alone was 6.89 (95% CI 3.99–11.91) and for CAG plus PCI was 2.95 (95% CI 1.59–5.47). After propensity matching, CAG was associated with an aOR for survival of 2.10 (95% CI 1.30–3.55) and for CPC 1/2 it was 5.06 (95% CI 2.29–11.19).
In OHCA without STE, CAG was strongly and independently associated with survival regardless of whether PCI was performed. The association between CAG and positive outcomes remained after propensity matching.
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Published online: March 13, 2018
Accepted: March 12, 2018
Received in revised form: January 12, 2018
Received: October 17, 2017
☆A Spanish translated version of the abstract of this article appears as Appendix in the final online version at https://doi.org/10.1016/j.resuscitation.2018.03.023.
© 2018 Elsevier B.V. All rights reserved.