title: Cardiac receiving centers:  beyond hypothermia.
abstract: OBJECTIVE
  The role of cardiac arrest centers, more recently termed Cardiac Receiving Centers, in improving outcomes after successful resuscitation is becoming more and more convincing. But which of all the treatments provided by Cardiac Receiving Centers are most beneficial is less certain. This review examines the role of early coronary angiography and percutaneous coronary intervention in this regard.
  
  
  RESULTS
  Cohort studies have consistently found that early coronary angiography is associated with improved long-term outcomes postcardiac arrest. The most common cause for out-of-hospital cardiac arrest is a myocardial ischemic event. Diagnosing and treating the underlying coronary trigger makes good physiological sense. The major issues are 'who' should undergo emergent coronary angiography and 'when' should it be done. Standard criteria such as ST segment elevation and precedent chest pains are not very sensitive in identifying those postcardiac arrest with an occluded or culprit lesion. As many as one in four postresuscitated patients without ST elevation have a significant culprit lesion, including at times an acutely occluded coronary. Cardiac Receiving Centers should have the capacity to perform emergent coronary angiography on every resuscitated patient who does not have an obvious noncardiac cause for their arrest.
  
  
  CONCLUSIONS
  Emergent coronary angiography and percutaneous coronary intervention are the most important Cardiac Receiving Center treatments beyond hypothermia. Providing both of these essential postresuscitation therapies is the very purpose of such centers.
authors.affiliation: Sarver Heart Center, University of Arizona, Tucson, Arizona 85724, USA. kernk@e-mail.arizona.edu
authors.forename: Karl B
authors.initials: KB
authors.lastname: Kern
mesh_terms: D001786:Blood Glucose; D002300:Cardiac Care Facilities / Q000458:organization & administration*; D016887:Cardiopulmonary Resuscitation / Q000379:methods; D017023:Coronary Angiography; D004562:Electrocardiography; D006801:Humans; D007036:Hypothermia, Induced; D009204:Myocardial Revascularization; D058687:Out-of-Hospital Cardiac Arrest / Q000175:diagnosis* / Q000601:surgery* / Q000628:therapy; D012121:Respiration, Artificial
chemical_list: D001786:Blood Glucose