What is the rate of coronary occlusion in out of hospital cardiac arrest (OHCA)?
We know that only 30% of patients having an OHCA have ST elevation myocardial infarction (STEMI) on their ecg. In those patients with a Non-STEMI, up to 30% will have coronary artery occlusion (1-3). How do we make sense of it all?
We would assume that the ECG following ROSC may show significant changes of ischaemia. Can we use this initial ECG to predicting STEMI, given that false positive signs of ischaemia may be present, due to low or no flow, during the arrest?
The message in this study, is that we should perhaps wait, before activating the cath lab. The question is; How long do we wait? Read on to find the answer.
The Study:
The Post-ROSC Electrocardiogram After Cardiac Arrest (PEACE) Study.
Baldi E., et al. Association of Timing of Electrocardiogram Acquisition After Return of Spontaneous Circulation With Coronary Angiography Findings in Patients With Out-of-Hospital Cardiac Arrest. JAMA Network Open. 2021;4(1):e2032875.doi:10.1001/jamanetworkopen.2020.32875
This is content for subscribers.
For less than the price of a cup of coffee a week, you can get full access to everything
References
- Spaulding CM, et al. Immediate coronary angiography in survivors of out-of-hospital cardiac arrest. NEJM 1997;336:1629–33.
- Noc M, et al. Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI)/Stent for Life (SFL) groups. EuroIntervention: J EuroPCR Collaboration Working Group Interventional Cardiol Europ Soc Cardiol 2014;10:31–7.
- Kern KB, et al. Outcomes of comatose cardiac arrest survivors with and without ST-segment elevation myocardial infarction: importance of coronary angiography. JACC Cardiovascular Interventions 2015;8:1031–40.
