Document Detail


Primary percutaneous coronary intervention after out-of-hospital cardiac arrest: patients and outcomes.
MedLine Citation:
PMID:  17491217     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The decision to perform primary percutaneous coronary intervention in unconscious patients resuscitated after out-of-hospital cardiac arrest is challenging because of uncertainty regarding the prognosis of recovery of anoxic brain damage and difficulties in interpreting ST segment deviations. In ST elevation myocardial infarction patients after OHCA, primary PCI is generally considered the only option for reperfusion. There are few published studies and no randomized trial has yet been performed in this specific group of patients. OBJECTIVES: To define the demographic, clinical and angiographic characteristics, and the prognosis of STEMI patients undergoing primary PCI after out-of-hospital cardiac arrest. METHODS: We performed a retrospective analysis of medical records and used the prospectively acquired information from the Rambam Primary Angioplasty Registry (PARR) and the Rambam Intensive Cardiac Care (RICCa) databases. RESULTS: During the period March 1998 to June 2006, 25 STEMI patients (21 men and 4 women, mean age 56 +/- 11years) after OHCA were treated with primary PCI. The location of myocardial infarction was anterior in 13 patients (52%) and non-anterior in 12 (48%). Cardiac arrest was witnessed in 23 patients (92%), but bystander resuscitation was performed in only 2 patients (8%). Eighteen patients (72%) were unconscious on admission, and Glasgow Coma Scale > 5 was noted in 2 patients (8%). Cardiogenic shock on admission was diagnosed in 4 patients (16%). PCI procedure was successful in 22 patients (88%). In-hospital, 30 day, 6 month and 1 year survival was 76%, 76%, 76% and 72%, respectively. In-hospital, 30 day, 6 month and 1 year survival without severe neurological disability was 68%, 68%, 68% and 64%, respectively. CONCLUSIONS: In a selected group of STEMI patients after out-of-hospital cardiac arrest, primary PCI can be performed with a high success rate and provides reasonably good results in terms of short and longer term survival.
Authors:
Erez Marcusohn; Erez Markusohn; Ariel Roguin; Anat Sebbag; Doron Aronson; Robert Dragu; Shlomo Amikam; Monter Boulus; Ehud Grenadier; Arthur Kerner; Eugenia Nikolsky; Walter Markiewicz; Haim Hammerman; Michael Kapeliovich
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The Israel Medical Association journal : IMAJ     Volume:  9     ISSN:  1565-1088     ISO Abbreviation:  Isr. Med. Assoc. J.     Publication Date:  2007 Apr 
Date Detail:
Created Date:  2007-05-11     Completed Date:  2007-06-05     Revised Date:  2009-01-26    
Medline Journal Info:
Nlm Unique ID:  100930740     Medline TA:  Isr Med Assoc J     Country:  Israel    
Other Details:
Languages:  eng     Pagination:  257-9     Citation Subset:  IM    
Affiliation:
Faculty of Health Sciences, Ben-Gurion University of the Negev, Beer Sheva, Israel.
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Angioplasty, Transluminal, Percutaneous Coronary / methods*
Coronary Angiography
Female
Follow-Up Studies
Heart Arrest / etiology,  physiopathology,  therapy*
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction / complications*,  physiopathology,  therapy
Outpatients*
Retrospective Studies
Survival Rate
Treatment Outcome
Comments/Corrections
Erratum In:
Isr Med Assoc J. 2008 Dec;10(12):910
Note: Markusohn, Erez [corrected to Marcusohn, Erez]

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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