Abstract
Introduction
The relations between specific ECG patterns and coronary angiographic findings in
cardiac arrest patients with different comorbidities are not properly assessed. More
evidence is needed to identify patients with the highest risk for acute coronary artery
disease as a cause of the cardiac arrest. This study aims to describe the coronary
artery findings after cardiac arrest in relation to ECG and comorbidity.
Method
A retrospective study of out-of-hospital cardiac arrest patients, with coronary angiography
performed within 28 days. ECG on admission, comorbidity, PCI attempts and angiographic
findings are described. Data were retrieved from national registries in Sweden.
Results
Among 1133 patients with available ECG and angiography information the mean age was
64 years. The rate of shockable rhythm was 79%. The total incidence of any significant
stenosis in cardiac arrest patients without ST-elevation who underwent coronary angiography
within 28 days was 71%. The incidence of any stenosis in patients with normal ECG
was 62.1% and in patients with LBBB, 59.3%. In patients with ST-depression or RBBB,
PCI attempts were made in 47.1% and 42.4% respectively, compared with 33.3% in patients
with normal ECG. Among patients without ST-elevation, those with diabetes mellitus
and those with initial shockable rhythm respectively, 84.8% and 71.5 had at least
one significant stenosis.
Conclusion
Our study suggests, that evaluation of ECG patterns and comorbidities in out-of-hospital
cardiac arrest patients without ST-segment elevation may be important to identify
those with a high risk of coronary artery lesions that could benefit from early revascularization.
Keywords
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Article info
Publication history
Published online: September 24, 2019
Accepted:
September 16,
2019
Received in revised form:
August 15,
2019
Received:
March 17,
2019
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2019 Elsevier B.V. All rights reserved.
