Key result
CPR during angiography or PCI is linked to ~56% discharge survival and comparable long-term outcomes.
Why the study?
The incidence, outcomes, and predictors of survival after cardiopulmonary resuscitation during coronary angiography and PCI were not well characterized over time.
Cohort (n=51,985)
Patients requiring CPR during cardiac catheterization have a relatively high rate of survival to hospital discharge (56.1%), with long-term survival comparable to matched controls without arrest.
Patients surviving periprocedural CPR during CA/PCI achieve long-term survival comparable to matched non-arrest controls; leaves open whether contemporary protocols improve outcomes.
In Brief We studied the outcome of cardiopulmonary resuscitation (CPR) in patients undergoing coronary angiography (CA) and/or percutaneous coronary interventions (PCI). Of 51,985 CA and PCI patients treated between January 1, 1990, and December 31, 2000, 114 required CPR. Records were reviewed for relationships between patient characteristics and various procedures and short-term survival. Long-term survival was compared with that of a matched cohort of patients who did not have an arrest during catheterization and a matched cohort from the general Minnesota population. Over the 11-year period, the overall incidence of CPR was 21.9 per 10,000 procedures. This rate decreased from 33.9 per 10,000 before 1995 to 13.1 per 10,000 after 1995. Overall survival to hospital discharge after CPR was 56.1%. Survival to discharge was less frequent with a history of congestive heart failure, previous coronary artery bypass graft surgery, hemodynamic instability during the procedure, and with prolonged or emergent catheterizations. Pulseless electrical activity (versus asystole or ventricular fibrillation) indicated very poor short-term survival. Interestingly, short-term survival was not related to the extent of coronary artery disease. Long-term survival of patients who survived cardiac arrest was comparable to that of those who did not have arrest during catheterization. In conclusion, the incidence of periprocedural CPR during diagnostic or interventional coronary procedures decreased after 1995. Patients who received CPR in the cardiac catheterization lab have a remarkably frequent survival to hospital discharge rate. Long-term survival of these patients is only minimally reduced. IMPLICATIONS: The incidence of cardiac arrests requiring full cardiopulmonary resuscitation (CPR) during diagnostic or interventional coronary artery procedures decreased after 1995. Of patients who received CPR in the cardiac catheterization lab, 56.1% survived to be discharged. Long-term survival of these patients is only minimally reduced.
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Šprung et al. (2005) conducted a cohort in Patients undergoing coronary angiography and/or percutaneous coronary interventions (n=51,985). Cardiopulmonary resuscitation (CPR) vs. Patients without cardiac arrest during catheterization was evaluated on Survival to hospital discharge. Cardiopulmonary resuscitation during coronary angiography or percutaneous coronary interventions was associated with a 56.1% survival to hospital discharge rate and comparable long-term survival.
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