Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest

We evaluated the association between early coronary angiography (CAG) and outcomes in resuscitated out-of-hospital cardiac arrest (OHCA) patients, by linking data from the Singapore Pan-Asian Resuscitation Outcomes Study, with a national registry of cardiac procedures. The 30-day survival and neurol...

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Autores principales:	Shir Lynn Lim, Yee How Lau, Mark Y. Chan, Terrance Chua, Huay Cheem Tan, David Foo, Zhan Yun Lim, Boon Wah Liew, Nur Shahidah, Desmond R. Mao, Si Oon Cheah, Michael Y. C. Chia, Han Nee Gan, Benjamin S. H. Leong, Yih Yng Ng, Khung Keong Yeo, Marcus E. H. Ong
Formato:	article
Lenguaje:	EN
Publicado:	MDPI AG 2021
Materias:	coronary angiography percutaneous coronary intervention out-of-hospital cardiac arrest 30-day survival neurological outcomes Medicine R
Acceso en línea:	https://doaj.org/article/981551ce5a5a405b96f15b70f1f2e93a
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spelling	oai:doaj.org-article:981551ce5a5a405b96f15b70f1f2e93a2021-11-11T17:47:49ZEarly Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest10.3390/jcm102151912077-0383https://doaj.org/article/981551ce5a5a405b96f15b70f1f2e93a2021-11-01T00:00:00Zhttps://www.mdpi.com/2077-0383/10/21/5191https://doaj.org/toc/2077-0383We evaluated the association between early coronary angiography (CAG) and outcomes in resuscitated out-of-hospital cardiac arrest (OHCA) patients, by linking data from the Singapore Pan-Asian Resuscitation Outcomes Study, with a national registry of cardiac procedures. The 30-day survival and neurological outcome were compared between patients undergoing early CAG (within 1-calender day), versus patients not undergoing early CAG. Inverse probability weighted estimates (IPWE) adjusted for non-randomized CAG. Of 976 resuscitated OHCA patients of cardiac etiology between 2011–2015 (mean(SD) age 64(13) years, 73.7% males), 337 (34.5%) underwent early CAG, of whom, 230 (68.2%) underwent PCI. Those who underwent early CAG were significantly younger (60(12) vs. 66(14) years old), healthier (42% vs. 59% with heart disease; 29% vs. 44% with diabetes), more likely males (86% vs. 67%), and presented with shockable rhythms (69% vs. 36%), compared with those who did not. Early CAG with PCI was associated with better survival and neurological outcome (adjusted odds ratio 1.91 and 1.82 respectively), findings robust to IPWE adjustment. The rates of bleeding and stroke were similar. CAG with PCI within 24 h was associated with improved clinical outcomes after OHCA, without increasing complications. Further studies are required to identify the characteristics of patients who would benefit most from this invasive strategy.Shir Lynn LimYee How LauMark Y. ChanTerrance ChuaHuay Cheem TanDavid FooZhan Yun LimBoon Wah LiewNur ShahidahDesmond R. MaoSi Oon CheahMichael Y. C. ChiaHan Nee GanBenjamin S. H. LeongYih Yng NgKhung Keong YeoMarcus E. H. OngMDPI AGarticlecoronary angiographypercutaneous coronary interventionout-of-hospital cardiac arrest30-day survivalneurological outcomesMedicineRENJournal of Clinical Medicine, Vol 10, Iss 5191, p 5191 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	coronary angiography percutaneous coronary intervention out-of-hospital cardiac arrest 30-day survival neurological outcomes Medicine R
spellingShingle	coronary angiography percutaneous coronary intervention out-of-hospital cardiac arrest 30-day survival neurological outcomes Medicine R Shir Lynn Lim Yee How Lau Mark Y. Chan Terrance Chua Huay Cheem Tan David Foo Zhan Yun Lim Boon Wah Liew Nur Shahidah Desmond R. Mao Si Oon Cheah Michael Y. C. Chia Han Nee Gan Benjamin S. H. Leong Yih Yng Ng Khung Keong Yeo Marcus E. H. Ong Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
description	We evaluated the association between early coronary angiography (CAG) and outcomes in resuscitated out-of-hospital cardiac arrest (OHCA) patients, by linking data from the Singapore Pan-Asian Resuscitation Outcomes Study, with a national registry of cardiac procedures. The 30-day survival and neurological outcome were compared between patients undergoing early CAG (within 1-calender day), versus patients not undergoing early CAG. Inverse probability weighted estimates (IPWE) adjusted for non-randomized CAG. Of 976 resuscitated OHCA patients of cardiac etiology between 2011–2015 (mean(SD) age 64(13) years, 73.7% males), 337 (34.5%) underwent early CAG, of whom, 230 (68.2%) underwent PCI. Those who underwent early CAG were significantly younger (60(12) vs. 66(14) years old), healthier (42% vs. 59% with heart disease; 29% vs. 44% with diabetes), more likely males (86% vs. 67%), and presented with shockable rhythms (69% vs. 36%), compared with those who did not. Early CAG with PCI was associated with better survival and neurological outcome (adjusted odds ratio 1.91 and 1.82 respectively), findings robust to IPWE adjustment. The rates of bleeding and stroke were similar. CAG with PCI within 24 h was associated with improved clinical outcomes after OHCA, without increasing complications. Further studies are required to identify the characteristics of patients who would benefit most from this invasive strategy.
format	article
author	Shir Lynn Lim Yee How Lau Mark Y. Chan Terrance Chua Huay Cheem Tan David Foo Zhan Yun Lim Boon Wah Liew Nur Shahidah Desmond R. Mao Si Oon Cheah Michael Y. C. Chia Han Nee Gan Benjamin S. H. Leong Yih Yng Ng Khung Keong Yeo Marcus E. H. Ong
author_facet	Shir Lynn Lim Yee How Lau Mark Y. Chan Terrance Chua Huay Cheem Tan David Foo Zhan Yun Lim Boon Wah Liew Nur Shahidah Desmond R. Mao Si Oon Cheah Michael Y. C. Chia Han Nee Gan Benjamin S. H. Leong Yih Yng Ng Khung Keong Yeo Marcus E. H. Ong
author_sort	Shir Lynn Lim
title	Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
title_short	Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
title_full	Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
title_fullStr	Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
title_full_unstemmed	Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest
title_sort	early coronary angiography is associated with improved 30-day outcomes among patients with out-of-hospital cardiac arrest
publisher	MDPI AG
publishDate	2021
url	https://doaj.org/article/981551ce5a5a405b96f15b70f1f2e93a
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Early Coronary Angiography Is Associated with Improved 30-Day Outcomes among Patients with Out-of-Hospital Cardiac Arrest

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