Interruption of the perivascular sympathetic nerves can alleviate CA-induced hypoperfusion and neuronal cell death in the CA1 region of the hippocampus to enhance functional learning and memory.

Objectives Out‐of‐hospital cardiac arrest (OHCA) afflicts >350,000 people annually in the United States. While postarrest coronary angiography (CAG) with percutaneous coronary intervention (PCI) has been associated with improved survival in observational cohorts, substantial uncertainty exists regarding patient selection for postarrest CAG. We tested the hypothesis that symptoms consistent with acute coronary syndrome (ACS), including chest discomfort, prior to OHCAs are associated with significant coronary lesions identified on postarrest CAG. Methods We conducted a multicenter retrospective cohort study among eight regional hospitals. Adult patients who experienced atraumatic OHCA with successful initial resuscitation and subsequent CAG between January 2015 and December 2019 were included. We collected data on prehospital documentation of potential ACS symptoms prior to OHCA as well as clinical factors readily available during postarrest care. The primary outcome in multivariable regression modeling was the presence of significant coronary lesions (defined as >50% stenosis of left main or >75% stenosis of other coronary arteries). Results Four‐hundred patients were included. Median (interquartile range) age was 59 (51–69) years; 31% were female. At least one significant stenosis was found in 62%, of whom 71% received PCI. Clinical factors independently associated with a significant lesion included a history of myocardial infarction (adjusted odds ratio [aOR] = 6.5, [95% confidence interval {CI} = 1.3 to 32.4], p = 0.02), prearrest chest discomfort (aOR = 4.8 [95% CI = 2.1 to 11.8], p ≤ 0.001), ST‐segment elevations (aOR = 3.2 [95% CI = 1.7 to 6.3], p < 0.001), and an initial shockable rhythm (aOR = 1.9 [95% CI = 1.0 to 3.4], p = 0.05). Conclusions Among survivors of OHCA receiving CAG, history of prearrest chest discomfort was significantly and independently associated with significant coronary artery lesions on postarrest CAG. This suggests that we may be able to use prearrest symptoms to better risk stratify patients following OHCA to decide who will benefit from invasive angiography.

-Saturated fatty acids have been traditionally thought to be detrimental in circulation. However, we describe the beneficial effects of palmitic and stearic acid methyl esters as it relates to neuroprotection and cerebral vasodilatory properties in global and focal cerebral ischemia. The methyl esterification of fatty acids is not prominent in nature. However, it seems to have biological activity related to neuroprotection/vasodilation. We will discuss the etiology of cerebral ischemia such as stroke and cardiac arrest in terms of current and future treatment modalitiesas it relates to fatty acid-based therapies. This review is based on the meeting presentation at the "The Journées Chevreul, Lipids & Brain III 2015" in Paris on 16-18 March, 2015.Keywords: Cerebral ischemia / cerebral blood flow / neuroprotection / palmitic acid methyl ester / protein arginine methyltransferase Résumé -Les esters méthyliques d'acides gras comme possible thérapie contre l'ischémie cérébrale. Les acides gras saturés ont été de longue date considérés comme délétères pour la circulation sanguine. Cependant, nous décrivons dans cet article les effets bénéfiques d'esters méthyliques d'acides palmitique et stéarique en ce qui concerne la neuroprotection, ainsi que les propriétés de vasodilatation au niveau cérébral face à l'ischémie cérébrale globale et focale. L'estérification méthylique d'acides gras n'est pas très répandue dans la nature. Cependant, elle semble avoir une activité biologique neuroprotectrice/vasodilatatrice. Nous discutons, dans cet article, de l'étiologie de l'ischémie cérébrale de type AVC et arrêt cardiaque, et ce en termes de modalités de traitement, actuels et futurs, en ce qui concerne les thérapies à base d'acide gras. Cette revue est basée sur la présentation faite à l'occasion de la conférence « Les Journées Chevreul, Lipids & Brain III 2015 » qui s'est tenue à Paris les 16-18 Mars 2015.Mots clés : Ischémie cérébrale / circulation sanguine cérébrale / neuroprotection / ester méthylique d'acide palmitique / arginine méthyltransférase

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