Percutaneous coronary intervention for postcardiac arrest syndrome.
OBJECTIVE
Sudden cardiac arrest is a major cause of unexpected death, as well as a major clinical issue. Primary percutaneous coronary intervention (PCI) can drastically improve outcomes among patients with ST-elevation myocardial infarction without cardiac arrest. Recent studies reported that using emergency PCI to resuscitate patients has the potential to improve their outcomes. The purpose of this review is to elucidate the effects of PCI among resuscitated patients.


RESULTS
To the best of current understanding, no randomized clinical trial has assessed PCI for postcardiac arrest syndrome. Several observational studies suggested a positive effect of PCI for resuscitated out-of-hospital cardiac arrest (OHCA) patients, and a number of observational studies reported a limited beneficial effect. Several studies reported that a combination of therapeutic hypothermia and PCI may be feasible and effective. However, the presence of bias and unmeasured confounders in these studies may have affected the outcomes.


CONCLUSIONS
PCI for postcardiac arrest syndrome may improve outcomes of OHCA patients; however, randomized trials of PCI for postcardiac arrest syndrome are necessary to confirm this issue. Alternative cardiopulmonary resuscitation using venoarterial extracorporeal membrane oxygenation and PCI may have the potential to improve the outcomes of refractory cardiac arrest patients.
aDepartment of Cardiology, Hiroshima City Asa Hospital bDepartment of Cardiovascular Medicine, Hiroshima University Graduate School of Biomedical Science, Hiroshima, Japan.
Eisuke
E
Kagawa
Keigo
K
Dote
Yasuki
Y
Kihara
D016887:Cardiopulmonary Resuscitation; D003131:Combined Modality Therapy; D015199:Extracorporeal Membrane Oxygenation / Q000379:methods; D006323:Heart Arrest / Q000628:therapy*; D006801:Humans; D007036:Hypothermia, Induced / Q000379:methods; D058687:Out-of-Hospital Cardiac Arrest / Q000628:therapy; D062645:Percutaneous Coronary Intervention; D016896:Treatment Outcome