Should we perform a coronary angiography in all cardiac arrest survivors?
OBJECTIVE
Percutaneous coronary revascularization is the cornerstone treatment of acute coronary syndromes. Out-of-hospital cardiac arrest (OHCA) is in most cases related to a culprit coronary occlusion and should be treated as soon as possible.


RESULTS
To date, no biomarker has been evidenced to correctly predict culprit coronary occlusion in OHCA patients in order to select the best candidates for coronary angiography after OHCA. Moreover, successful percutaneous coronary intervention has been associated with better ICU and long-term survival in such patients. Although all these data are provided by retrospective studies, results can be considered strong enough to support systematic coronary angiography after OHCA. Taken together, these findings strongly suggest the necessity to systematically perform coronary angiography after no obvious noncardiac cause of OHCA.


CONCLUSIONS
Systematic percutaneous coronary intervention after no obvious noncardiac cause of OHCA appears to be the most secure and the best adapted in these patients.
aMedical Intensive Care Unit bEmergency Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris cParis Descartes University dSudden Death Expertise Centre, Paris Cardiovascular Research Centre, INSERM U970 (team 4), Paris, France.
Guillaume
G
Geri
Florence
F
Dumas
Alain
A
Cariou
D015415:Biomarkers; D016887:Cardiopulmonary Resuscitation; D017023:Coronary Angiography / Q000379:methods; D003362:Cost-Benefit Analysis; D006323:Heart Arrest / Q000401:mortality / Q000503:physiopathology / Q000628:therapy*; D006801:Humans; D018579:Patient Selection; D062645:Percutaneous Coronary Intervention; D017410:Practice Guidelines as Topic; D011379:Prognosis; D017741:Survivors; D013997:Time Factors; D016896:Treatment Outcome
D015415:Biomarkers