Coronary artery diseaseComparison of Role of Early (Less Than Six Hours) to Later (More Than Six Hours) or No Cardiac Catheterization After Resuscitation From Out-of-Hospital Cardiac Arrest
Section snippets
Methods
This study included 240 consecutive patients who were resuscitated from out-of-hospital rSCA with ventricular fibrillation or tachycardia as the first identified rhythm. At successful resuscitation the patients were transported to 1 of 11 receiving hospitals, all but 1 with cardiac catheterization facilities. The incidents occurred from January 6, 1999 through December 15, 2002, a period before widespread use of therapeutic hypothermia for resuscitated ventricular fibrillation patients in
Results
Of the 240 patients, 25% underwent acute cardiac catheterization (≤6-hour group) and 75% did not (>6-hour group). In the >6-hour group, 43 underwent cardiac catheterization 6 hours after hospital admission and 136 did not undergo this procedure. Patients in the ≤6-hour group were 3 years younger and more often men, although the racial distribution was similar in the 2 groups (Table 1). With respect to medical histories, patients in the ≤6-hour group less often had previously recognized coronary
Discussion
In this series of patients who sustained out-of-hospital cardiac arrest, acute catheterization (defined as the procedure performed within the first 6 hours) was associated with improved survival in bivariate and multivariate analyses compared to the group receiving no catheterization or after 6 hours. In addition, using propensity scoring to identify patients with a higher likelihood of receiving acute catheterization identified a subpopulation of patients in whom acute catheterization was
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Cited by (0)
This work was supported by a grant from the Medic One Foundation, Seattle, Washington, and Grant RO1 HL089554 from the National Institutes of Health/National Heart, Lung, and Blood Institute, Bethesda, Maryland (Dr. Kim).