title: Routine angiography in survivors of out of hospital cardiac arrest with return of spontaneous circulation: a single site registry.
abstract: BACKGROUND
  Coronary revascularization in resuscitated out of hospital cardiac arrest (OOHCA) patients has been associated with improved survival.
  
  
  METHODS
  This was a retrospective review of patients with OOHCA between 01/07/2007 and 31/03/2009 surviving to hospital admission. Cardiac risk factors, demographics, treatment times, electrocardiogram (ECG), angiographic findings and in-hospital outcomes were recorded.
  
  
  RESULTS
  Of the 78 patients, 63 underwent coronary angiography. Traditional cardiac risk factors were common in this group. Chest pain occurred in 33.3% pre-arrest, 59.0% were initially treated at a peripheral hospital, 83.3% had documented ventricular tachycardia or ventricular fibrillation, 55.1% had specific ECG changes, 65.4% had acute myocardial infarction (AMI) as the cause of OOHCA and the majority had multi-vessel disease. ST elevation strongly predicted AMI. The in-hospital survival was 67.9% with neurological deficit in 13.2% of survivors. The group of patients who had an angiogram were more likely to have AMI as a cause of cardiac arrest (71.4% vs 40.0%, p = 0.01) and more likely to have survived to discharge (74.6% vs 40.0%, p < 0.01). Poor outcome was associated with older age, cardiogenic shock, longer transfer times, diabetes, renal impairment and a long duration to return of spontaneous circulation.
  
  
  CONCLUSIONS
  Acute myocardial infarction was the commonest cause of OOHCA and a high rate of survival to discharge was seen with a strategy of routine angiography and revascularization.
authors.affiliation: Heart Lung Institute, The Prince Charles Hospital, Brisbane, Australia. vwijesekera@outlook.com.
authors.forename: Vishva A
authors.initials: VA
authors.lastname: Wijesekera
authors.forename: Daniel V
authors.initials: DV
authors.lastname: Mullany
authors.forename: Catherina A
authors.initials: CA
authors.lastname: Tjahjadi
authors.forename: Darren L
authors.initials: DL
authors.lastname: Walters
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001145:Arrhythmias, Cardiac / Q000150:complications / Q000628:therapy; D001775:Blood Circulation; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000150:complications / Q000628:therapy; D004562:Electrocardiography; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D007902:Length of Stay; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000150:complications / Q000628:therapy; D009204:Myocardial Revascularization; D058687:Out-of-Hospital Cardiac Arrest / Q000000981:diagnostic imaging* / Q000209:etiology / Q000503:physiopathology / Q000628:therapy*; D010343:Patient Admission; D010351:Patient Discharge; D011237:Predictive Value of Tests; D011793:Queensland; D020127:Recovery of Function; D012042:Registries; D012151:Resuscitation; D012189:Retrospective Studies; D012307:Risk Factors; D017741:Survivors; D013997:Time Factors; D014187:Transportation of Patients; D016896:Treatment Outcome; D055815:Young Adult