| Coronary angiography predicts improved outcome following cardiac arrest: propensity-adjusted analysis. | |
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MedLine Citation:
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PMID: 19321536 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVES: Determine if clinical parameters of resuscitated patients predict coronary angiography (CATH) performance and if receiving CATH after cardiac arrest is associated with outcome. INTRODUCTION: CATH is associated with survival in patients suffering out-of-hospital cardiac arrest (OHCA) from ventricular fibrillation or ventricular tachycardia(VF/VT). Its effect on outcome in other cohorts is unknown. METHODS: Chart review of resuscitated cardiac arrest patients between 2005 and 2007. Exclusion criteria: immediate withdrawal of care, hemodynamic collapse, or neurologic exam under sedation. Clinical parameters included Glasgow Coma Scale (GCS) arrest location, presenting rhythm, age, and acute ischemic ECG changes (new left bundle branch block or ST-elevation myocardial infarction-STEMI). Logistic regression identified clinical parameters predicting CATH. The association between CATH and good outcome (discharge home or to acute rehabilitation facility) was determined using logistic regression adjusting for likelihood of receiving CATH via propensity score. RESULT: Of the 241 patients, 96 (40%) received CATH. Significant disease (>or=70% stenosis) of >or=1 coronary arteries was identified in 69% of patients including 57% of patients without acute ischemic ECG changes. Unadjusted predictors of CATH were sex, method of arrival, OHCA, presenting rhythm, acute ischemic ECG changes, and GCS. Propensity adjusted logistic regression demonstrated an association between CATH and good outcome (OR 2.16; 95% CI 1.12, 4.19; P<0.02). CONCLUSION: CATH is more likely to be performed in certain patients and identifies a significant number of high-grade stenoses in this population. Receiving CATH was independently associated with good outcome. |
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Authors:
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Joshua C Reynolds; Clifton W Callaway; Samar R El Khoudary; Charity G Moore; René J Alvarez; Jon C Rittenberger |
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Publication Detail:
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Type: Journal Article; Research Support, N.I.H., Extramural; Research Support, Non-U.S. Gov't; Review Date: 2009-03-25 |
Journal Detail:
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Title: Journal of intensive care medicine Volume: 24 ISSN: 0885-0666 ISO Abbreviation: J Intensive Care Med Publication Date: 2009 May-Jun |
Date Detail:
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Created Date: 2009-05-22 Completed Date: 2009-08-04 Revised Date: 2010-09-23 |
Medline Journal Info:
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Nlm Unique ID: 8610344 Medline TA: J Intensive Care Med Country: United States |
Other Details:
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Languages: eng Pagination: 179-86 Citation Subset: IM |
Affiliation:
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Department of Emergency Medicine, University of Maryland, Baltimore, Maryland, USA. |
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| MeSH Terms | |
Descriptor/Qualifier:
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Coronary Angiography* Female Heart Arrest / mortality*, radiography* Humans Male Middle Aged |
| Grant Support | |
ID/Acronym/Agency:
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1 KL2 RR024154-02/RR/NCRR NIH HHS; L30 HL090007-02/HL/NHLBI NIH HHS |
| Comments/Corrections | |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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