Role of emergent coronary angiography in the management of patients resuscitated from out-of-hospital cardiac arrest: From literature review to clinical practice

Ilaria Armellini, Davide Zanuttini, Gaetano Nucifora, Alessandro Proclemer

Research output: Contribution to journalReview article

Abstract

Out-of-hospital cardiac arrest is a relatively common event. Acute coronary thrombotic events are the main trigger of sudden cardiac arrest. Mortality of patients, in whom return of spontaneous circulation is obtained, is still high, mainly due to anoxic brain injury and progressive cardiac failure. In the last years, the implementation of "post-cardiac arrest care" led to a significant improvement of hospital survival of these patients. Mild therapeutic hypothermia has become the foundation for improvement of survival with good neurological outcome after cardiac arrest. Recently, there is a growing interest in emergent invasive coronary strategies, including emergent coronary angiography and subsequent percutaneous coronary interventions when indicated. Emergent coronary angiography is strongly recommended in patients with ST-segment elevation on the ECG performed after return of spontaneous circulation. Conversely, whether patients without ST-segment elevation on ECG or patients who remain unconscious after return of spontaneous circulation should always undergo emergent coronary angiography is still unclear. Recent observational studies have shown that emergent invasive coronary strategies may improve hospital survival also in this patient subset. This suggests that resuscitated cardiac arrest victims without an obvious non-cardiac etiology should always undergo emergent coronary angiography, in association with therapeutic hypothermia if indicated.

Translated title of the contributionRole of emergent coronary angiography in the management of patients resuscitated from out-of-hospital cardiac arrest: From literature review to clinical practice
LanguageItalian
Pages79-89
Number of pages11
JournalGiornale Italiano di Cardiologia
Volume15
Issue number2
Publication statusPublished - 2014
Externally publishedYes

Keywords

  • Coronary angiography
  • Coronary artery disease
  • Out-of-hospital cardiac arrest
  • Percutaneous coronary intervention
  • Post-resuscitation care

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

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title = "Ruolo dello studio coronarografico urgente nella gestione dei pazienti rianimati da arresto cardiaco extraospedaliero: dalla revisione della letteratura alla pratica clinica",
abstract = "Out-of-hospital cardiac arrest is a relatively common event. Acute coronary thrombotic events are the main trigger of sudden cardiac arrest. Mortality of patients, in whom return of spontaneous circulation is obtained, is still high, mainly due to anoxic brain injury and progressive cardiac failure. In the last years, the implementation of {"}post-cardiac arrest care{"} led to a significant improvement of hospital survival of these patients. Mild therapeutic hypothermia has become the foundation for improvement of survival with good neurological outcome after cardiac arrest. Recently, there is a growing interest in emergent invasive coronary strategies, including emergent coronary angiography and subsequent percutaneous coronary interventions when indicated. Emergent coronary angiography is strongly recommended in patients with ST-segment elevation on the ECG performed after return of spontaneous circulation. Conversely, whether patients without ST-segment elevation on ECG or patients who remain unconscious after return of spontaneous circulation should always undergo emergent coronary angiography is still unclear. Recent observational studies have shown that emergent invasive coronary strategies may improve hospital survival also in this patient subset. This suggests that resuscitated cardiac arrest victims without an obvious non-cardiac etiology should always undergo emergent coronary angiography, in association with therapeutic hypothermia if indicated.",
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Ruolo dello studio coronarografico urgente nella gestione dei pazienti rianimati da arresto cardiaco extraospedaliero : dalla revisione della letteratura alla pratica clinica. / Armellini, Ilaria; Zanuttini, Davide; Nucifora, Gaetano; Proclemer, Alessandro.

In: Giornale Italiano di Cardiologia, Vol. 15, No. 2, 2014, p. 79-89.

Research output: Contribution to journalReview article

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