Key result
Multivessel coronary artery disease was independently associated with a significantly higher risk of late return of spontaneous circulation (>20 minutes) in patients with out-of-hospital cardiac arrest (OR 7.71).
Why the study?
The relationship between coronary angiographic findings and return of spontaneous circulation interval in acute coronary syndrome patients with out-of-hospital cardiac arrest is unknown.
Does multivessel coronary artery disease prolong the return of spontaneous circulation interval in ACS patients with out-of-hospital cardiac arrest?
Cohort (n=58)
No
Does multivessel coronary artery disease prolong the return of spontaneous circulation interval in ACS patients with out-of-hospital cardiac arrest?
Answers are grounded in this paper and cite their sources.
In OHCA patients with ACS and initial shockable rhythms, multivessel coronary artery disease is strongly associated with prolonged resuscitation times and worse 30-day outcomes.
Acute coronary syndrome (ACS) is the major cause of out-of-hospital cardiac arrest (OHCA). The relationship between the findings from the study of coronary images and return of spontaneous circulation (ROSC) interval is still unknown. Hence, we investigated this relationship in ACS patients with OHCA.A cohort of 2779 patients was admitted to our emergency center due to cardiopulmonary arrest (CPA) between April 2011 and March 2015. We included ACS patients who had CPA with ventricular fibrillation (VF) as an initial rhythm, were successfully resuscitated, underwent coronary angiography (CAG), had a culprit lesion, and were diagnosed with ACS (n = 58; age, 63.7 ± 12.0 years; 93.1% male).We divided the 58 patients into two groups, an early ROSC group (ROSC ≤ 20 minutes: E-ROSC) and a late ROSC group (ROSC > 20 minutes: L-ROSC), and then analyzed their characteristics.The finding of a collateral artery for the culprit lesion location, Rentrop II-III, and TIMI III flow on CAG on arrival presented no significant differences between the two groups (Rentrop II-III: 25.0% versus 23.5%, P = 0.90; TIMI III: 33.3% versus 35.3%, P = 0.88). The incidence of multivessel coronary artery disease (MVD) was lower in the E-ROSC group than in the L-ROSC group (16.7% versus 58.8%, P = 0.001).Collateral and TIMI flow were not associated with ease of resuscitation, but MVD may have a negative impact on resuscitation, especially in VF patients.
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Tateishi et al. (2019) conducted a cohort in Acute coronary syndrome with out-of-hospital cardiac arrest (n=58). Multivessel coronary artery disease (MVD) vs. Single-vessel coronary artery disease (SVD) was evaluated on Late return of spontaneous circulation (ROSC > 20 minutes) (OR 7.71, 95% CI 1.72-34.5, p=0.008). Multivessel coronary artery disease was independently associated with a significantly higher risk of late return of spontaneous circulation (>20 minutes) in patients with out-of-hospital cardiac arrest (OR 7.71).
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