Urgent coronary angiography and angioplasty - a new element in chain of survival among victims of out-of-hospital cardiac arrest of probable cardiac etiology


Zeliaś, Aleksander


neurological outcome ; survival ; out-of-hospital cardiac arrest ; coronary angiography ; percutaneous coronary intervention


The main purpose of the study was to evaluate survival and neurological function of out-of-hospital cardiac arrest (OHCA) patients of probable cardiogenic origin admitted to urgent coronary angiography and angioplasty (UCA/PCI) in invasive cardiology center since 2000 until 2011. In addition, in 2009-2010, all patients who survived to hospital admission after OHCA in local EMS area were identified and survival of those who were subsequently admitted to UCA/PCI was compared to those who were not admitted. In 2000-2011 there was 405 OHCA patients admitted to UCA/PCI: 81% were men, average age was 61 years. Most (78%) had VF/VT, 70% were unconscious and 11% had cardiogenic shock on admission. Average time to ROSC was 26,7 min. In about 70% of patients there was ST segment elevation on ECG post-ROSC. Coronary angiography revealed acute coronary occlusion in 48% and critical coronary stenosis in 26%. Finally, 82% of patients were diagnosed acute coronary syndrome (ACS): 75% STEMI, 25% NSTEMI. The successful PCI was performed in 70% of patients with ACS. Survival to hospital discharge was 63% and good neurological outcome was 49%. The independent correlates of survival with good neurological state in patients that were initially unconscious were: absence of shock, cardiac arrest assisted by medical personnel, VF/VT as a primary mechanism of cardiac arrest and preserved renal function ; . OHCA patients admitted to UCA/PCI had significantly better survival rate than those who were not admitted (43% vs. 11%), but the former were younger, more often conscious on admission, more often had VF/VT and OHCA assisted by medical personnel.

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2 - studia doktoranckie

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choroby układu krążenia

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Wydział Lekarski


Żmudka, Krzysztof



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Praca doktorska

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