Trends and Outcomes of Coronary Angiography and Percutaneous Coronary Intervention After Out-of-Hospital Cardiac Arrest Associated With Ventricular Fibrillation or Pulseless Ventricular Tachycardia

Patel, Nish; Patel, Nileshkumar; Macon, Conrad; Thakkar, Badal; Desai, Mihir J.; Rengifo‐Moreno, Pablo; Alfonso, Carlos; Myerburg, Robert J.; Bhatt, Deepak L.; Cohen, Mauricio G.

doi:10.1001/jamacardio.2016.2860

Cited by 97 publications

(58 citation statements)

References 38 publications

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“…Inquiring into the management of CAD in patients resuscitated from a SCA, Patel et al analyzed temporal trends in the use of CC and PCI. They found that in the group of patients hospitalized after out‐of‐hospital SCA caused by shockable rhythms without ST elevation, PCI was performed in almost one third of the patients . In our cohort, 18.4% of patients were treated with PCI (21.6% among those with shockable initial rhythm).…”

Section: Discussionmentioning

confidence: 70%

“…Thus, Kaplan-Meier's curves including ≥50 DS% did not show was performed in almost one third of the patients. 23 In our cohort, 18.4% of patients were treated with PCI (21.6% among those with shockable initial rhythm). Although we did not specifically evaluate the effect of revascularization over prognosis, those patients with the highest burden of CAD (three vessel disease with DS% ≥70), could benefit from a revascularization as complete as possible to reduce mortality.…”

Section: Discussionmentioning

confidence: 80%

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Angiographic characteristics and long‐term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non‐diagnostic electrocardiogram

Nogales-Romo

Ferrera

Salinas

et al. 2018

Cathet Cardio Intervent

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Objectives Our purpose was to describe the prevalence, distribution, extension, and prognostic value of coronary artery disease (CAD) in patients resuscitated from sudden cardiac arrest (SCA) with non‐diagnostic electrocardiogram (ECG). Background The impact of CAD and the indication for cardiac catheterization (CC) in patients resuscitated from SCA with non‐diagnostic ECG are uncertain. Methods We included prospectively and consecutively 545 patients resuscitated from SCA with at least one CC during hospitalization. From them, 203 patients with a non‐diagnostic ECG formed our study population. Patients were followed‐up 5 years after discharge. Results Overall, 125 (61.6%) patients had significant CAD, and at least one acute culprit lesion was found in 25 (12.4%). Regarding the burden and complexity of CAD, 78 (38.4%) patients had a CAD Prognostic Index of 0 and a SYNTAX score of 0. There was higher 5‐year mortality only in patients with very high burden of CAD: three vessels with severe stenosis (P = 0.015) and CAD Prognostic Index Score ≥ 56 (P < 0.001). Tertiles of SYNTAX score did not predict higher 5‐year mortality. Conclusions In survivors from SCA with a non‐diagnostic ECG, significant CAD is highly prevalent. SYNTAX score was not associated with a different long‐term prognosis in this patient population. Patients with severe disease in the three main coronary vessels and patients with higher (≥56) CAD Prognostic Index Score had a worse long‐term prognosis.

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Section: Discussionmentioning

confidence: 70%

Section: Discussionmentioning

confidence: 80%

Angiographic characteristics and long‐term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non‐diagnostic electrocardiogram

Nogales-Romo

Ferrera

Salinas

et al. 2018

Cathet Cardio Intervent

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“…This resulted in a cohort of 151,628 hospitalizations which comprise our study sample. Ventricular tachycardia and VF were identified by the ICD‐9CM code 427.1 OR 427.41 . These codes have shown a positive predictive value of 82% .…”

Section: Methodsmentioning

confidence: 99%

“…Ventricular tachycardia and VF were identified by the ICD-9CM code 427.1 OR 427.41. 17 These codes have shown a positive predictive value of 82%. 18 Intraaortic balloon pump (IABP), percutaneous ventricular assist devices (PVADs), and extracorporeal membrane oxygenator (ECMO) were identified using the ICD-9CM codes 37.61, 37.68, and 39.65, respectively.…”

Section: Study Populationmentioning

confidence: 99%

Temporal trends of survival and utilization of mechanical circulatory support devices in patients with in‐hospital cardiac arrest secondary to ventricular tachycardia/ventricular fibrillation

Patel

Atti

Kumar

et al. 2019

Cathet Cardio Intervent

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Background Pulseless ventricular tachycardia/ventricular fibrillation (VT/VF) is the initial rhythm in a third of in‐hospital cardiac arrest patients. Mechanical circulatory support (MCS) device use remains poorly understood in this population. Methods We conducted an observational analysis of temporal trends in the utilization of MCS in VT/VF IHCA between January 2008 and December 2014 utilizing the Nationwide Inpatient Sample (NIS) database. Using multivariable analysis, we assessed factors associated with MCS use and survival to discharge. Results Among 151,628 hospitalizations with VT/VF IHCA, 14,981 (9.9%) received MCS. Intra‐aortic balloon pump (IABP) was the most commonly used MCS (9.1%). From 2008 to 2014, there was significant increase in the utilization of MCS (8.7–11%; ptrend < 0.0001). On multivariable analysis, there was 12‐fold increase and three‐fold increase in the utilization of PVAD and ECMO respectively; however, there was no significant change in the use of IABP. Over the seven‐year sample period, there was significant increase in the overall survival to hospital discharge (35.4–43.5%; ptrend < 0.0001). Survival to hospital discharge increased in both MCS and non‐MCS groups. Conclusion There was significant increase in utilization of MCS after VT/VF IHCA during the study period. IABP was the most commonly utilized MCS. The survival to hospital discharge increased in the overall study population including both MCS and non‐MCS groups. Future studies are needed to identify patient population most likely to benefit from the use of MCS after VT/VF IHCA.

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“…Recently, Patel et al published data of more than 400,000 patients with ventricular tachycardia or ventricular fibrillation (VT/VF) OHCA from the Nationwide Inpatient Sample (NIS) database. The study reports on trends of the application of coronary angiography (CAG) and percutaneous coronary intervention (PCI), as well as outcome after OHCA (1). Evidence that CAG may reduce mortality in OHCA patients with and without ST-segment elevation (STE) myocardial infarction (STEMI) was obtained in several previous observational studies (2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12).…”

mentioning

confidence: 99%

Coronary angiography and percutaneous coronary intervention after out-of-hospital cardiac arrest: major leaps towards improved survival?

et al. 2017

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Trends and Outcomes of Coronary Angiography and Percutaneous Coronary Intervention After Out-of-Hospital Cardiac Arrest Associated With Ventricular Fibrillation or Pulseless Ventricular Tachycardia

Cited by 97 publications

References 38 publications

Angiographic characteristics and long‐term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non‐diagnostic electrocardiogram

Angiographic characteristics and long‐term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non‐diagnostic electrocardiogram

Temporal trends of survival and utilization of mechanical circulatory support devices in patients with in‐hospital cardiac arrest secondary to ventricular tachycardia/ventricular fibrillation

Coronary angiography and percutaneous coronary intervention after out-of-hospital cardiac arrest: major leaps towards improved survival?

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