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The quest continues to identify coronary occlusion in OHCA without ST elevation

  • Patrick J. Coppler
    Affiliations
    Department of Emergency Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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  • Cameron Dezfulian
    Correspondence
    Corresponding author at: Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, 4401 Penn Avenue, CHP Faculty Pavilion Rm 2119, Pittsburgh, PA 15224, United States.
    Affiliations
    Safar Center for Resuscitation Research, Department of Critical Care Medicine, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States

    Heart and Vascular Medicine Institute, University of Pittsburgh School of Medicine, Pittsburgh, PA, United States
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      Current American Heart Association and European Resuscitation Council guideline statements provide Class I recommendations to pursue urgent coronary angiography for out-of-hospital cardiac arrest (OHCA) patients when ST segment elevation (STE) are present on electrocardiography (ECG) after return of spontaneous circulation (ROSC).
      • Callaway C.W.
      • Donnino M.W.
      • Fink E.L.
      • et al.
      Part 8: post-cardiac arrest care 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.
      • Nolan J.P.
      • Soar J.
      • Cariou A.
      • et al.
      European Resuscitation Council and European Society of Intensive Care Medicine guidelines for post-resuscitation care 2015: section 5 of the European Resuscitation Council guidelines for resuscitation 2015.
      In the absence of STE or alternative non-cardiac etiology, urgent angiography is a “reasonable” option though no guidance is provided on how to select these patients.
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      References

        • Callaway C.W.
        • Donnino M.W.
        • Fink E.L.
        • et al.
        Part 8: post-cardiac arrest care 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care.
        Circulation. 2015; 132: S465-S482
        • Nolan J.P.
        • Soar J.
        • Cariou A.
        • et al.
        European Resuscitation Council and European Society of Intensive Care Medicine guidelines for post-resuscitation care 2015: section 5 of the European Resuscitation Council guidelines for resuscitation 2015.
        Resuscitation. 2015; 95: 202-222
        • Spaulding C.M.
        • Joly L.M.
        • Rosenberg A.
        • et al.
        Immediate coronary angiography in survivors of out-of-hospital cardiac arrest.
        N Engl J Med. 1997; 336: 1629-1633
        • Dumas F.
        • Bougouin W.
        • Geri G.
        • et al.
        Emergency percutaneous coronary intervention in post-cardiac arrest patients without ST-segment elevation pattern: insights from the PROCAT II registry.
        JACC Cardiovasc Interv. 2016; 9: 1011-1018
        • Rab T.
        • Kern K.B.
        • Tamis-Holland J.E.
        • et al.
        Cardiac arrest: a treatment algorithm for emergent invasive cardiac procedures in the resuscitated comatose patient.
        J Am Coll Cardiol. 2015; 66: 62-73
        • Vyas A.
        • Chan P.S.
        • Cram P.
        • Nallamothu B.K.
        • McNally B.
        • Girotra S.
        Early coronary angiography and survival after out-of-hospital cardiac arrest.
        Circ Cardiovasc Interv. 2015; 8
        • Callaway C.W.
        • Schmicker R.H.
        • Brown S.P.
        • et al.
        Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest.
        Resuscitation. 2014; 85: 657-663
        • Dumas F.
        • Cariou A.
        • Manzo-Silberman S.
        • et al.
        Immediate percutaneous coronary intervention is associated with better survival after out-of-hospital cardiac arrest: insights from the PROCAT (Parisian Region Out of hospital Cardiac ArresT) registry.
        Circ Cardiovasc Interv. 2010; 3: 200-207
        • Jentzer J.C.
        • Scutella M.
        • Pike F.
        • et al.
        Early coronary angiography and percutaneous coronary intervention are associated with improved outcomes after out of hospital cardiac arrest.
        Resuscitation. 2018; 123: 15-21
        • Aurore A.
        • Jabre P.
        • Liot P.
        • Margenet A.
        • Lecarpentier E.
        • Combes X.
        Predictive factors for positive coronary angiography in out-of-hospital cardiac arrest patients.
        Eur J Emerg Med. 2011; 18: 73-76
        • Dumas F.
        • Manzo-Silberman S.
        • Fichet J.
        • et al.
        Can early cardiac troponin I measurement help to predict recent coronary occlusion in out-of-hospital cardiac arrest survivors?.
        Crit Care Med. 2012; 40: 1777-1784
        • Anyfantakis Z.A.
        • Baron G.
        • Aubry P.
        • et al.
        Acute coronary angiographic findings in survivors of out-of-hospital cardiac arrest.
        Am Heart J. 2009; 157: 312-318
        • Voicu S.
        • Sideris G.
        • Deye N.
        • et al.
        Role of cardiac troponin in the diagnosis of acute myocardial infarction in comatose patients resuscitated from out-of-hospital cardiac arrest.
        Resuscitation. 2012; 83: 452-458
        • Lemkes J.S.
        • Janssens G.N.
        • van der Hoeven N.W.
        • et al.
        Coronary angiography after cardiac arrest without ST-segment elevation.
        N Engl J Med. 2019; 380: 1397-1407
        • Taylor C.J.
        • Ordonez-Mena J.M.
        • Roalfe A.K.
        • et al.
        Trends in survival after a diagnosis of heart failure in the United Kingdom 2000–2017: population based cohort study.
        BMJ. 2019; 364: l223
        • Wallace D.J.
        • Coppler P.
        • Callaway C.
        • et al.
        Selection bias, interventions and outcomes for survivors of cardiac arrest.
        Heart. 2018; 104: 1356-1361
        • Reynolds J.C.
        • Rittenberger J.C.
        • Toma C.
        • Callaway C.W.
        • Post Cardiac Arrest Service
        Risk-adjusted outcome prediction with initial post-cardiac arrest illness severity: implications for cardiac arrest survivors being considered for early invasive strategy.
        Resuscitation. 2014; 85: 1232-1239
        • Lagedal R.
        • Elfwen L.
        • Jonsson M.
        • et al.
        Coronary angiographic findings after cardiac arrest in relation to ECG and comorbidity.
        Resuscitation. 2019;
        • Wilson M.
        • Grossestreuer A.V.
        • Gaieski D.F.
        • Abella B.S.
        • Frohna W.
        • Goyal M.
        Incidence of coronary intervention in cardiac arrest survivors with non-shockable initial rhythms and no evidence of ST-elevation MI (STEMI).
        Resuscitation. 2017; 113: 83-86
        • Harhash A.A.
        • Huang J.J.
        • Howe C.L.
        • Hsu C.H.
        • Kern K.B.
        Coronary angiography and percutaneous coronary intervention in cardiac arrest survivors with non-shockable rhythms and no STEMI: a systematic review.
        Resuscitation. 2019; 143: 106-113
        • Geri G.
        • Mongardon N.
        • Dumas F.
        • et al.
        Diagnosis performance of high sensitivity troponin assay in out-of-hospital cardiac arrest patients.
        Int J Cardiol. 2013; 169: 449-454
        • Bonow R.O.
        • Masoudi F.A.
        • Rumsfeld J.S.
        • et al.
        ACC/AHA classification of care metrics: performance measures and quality metrics: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures.
        J Am Coll Cardiol. 2008; 52: 2113-2117
        • Peberdy M.A.
        • Donnino M.W.
        • Callaway C.W.
        • et al.
        Impact of percutaneous coronary intervention performance reporting on cardiac resuscitation centers: a scientific statement from the American Heart Association.
        Circulation. 2013; 128: 762-773
        • Cournoyer A.
        • Notebaert E.
        • de Montigny L.
        • et al.
        Impact of the direct transfer to percutaneous coronary intervention-capable hospitals on survival to hospital discharge for patients with out-of-hospital cardiac arrest.
        Resuscitation. 2018; 125: 28-33
        • Dicker B.
        • Todd V.F.
        • Tunnage B.
        • Swain A.
        • Smith T.
        • Howie G.
        Direct transport to PCI-capable hospitals after out-of-hospital cardiac arrest in New Zealand: inequities and outcomes.
        Resuscitation. 2019; 142: 111-116
        • Shin H.
        • Jang B.H.
        • Lim T.H.
        • et al.
        Diagnostic accuracy of adding copeptin to cardiac troponin for non-ST-elevation myocardial infarction: a systematic review and meta-analysis.
        PLoS One. 2018; 13e0200379
        • Bergmann I.
        • Buttner B.
        • Teut E.
        • et al.
        Pre-hospital transthoracic echocardiography for early identification of non-ST-elevation myocardial infarction in patients with acute coronary syndrome.
        Crit Care. 2018; 22: 29