title: [Role of coronary intervention after successful cardiopulmonary resuscitation].
abstract: Immediate coronary angiography and intervention in suitable stenoses in patients resuscitated from cardiac arrest of presumed coronary origin and return of spontaneous circulation is widely established in interventional centers. The procedure is based on the analogy of positive results achieved with coronary intervention in many forms of acute coronary syndromes on the one hand and otherwise from registries showing promising data from coronary intervention of resuscitated patients. Results from randomized controlled studies, however, are not yet available. With respect to ST-elevation myocardial infarction, the diagnostic reliability of an ECG registered shortly after cardiopulmonary resuscitation is sufficient. The results of the registries are specifically promising for patients with ST-elevation myocardial infarction but less favorable for other forms of acute coronary syndromes. Moreover, insight into the results of the registries reveals that patients with the best prognostic conditions were preferentially selected for coronary intervention (e.g., younger patients, those with an initially shockable arrhythmia, bystander resuscitation), whereas those, for example, with cardiac or renal failure were excluded. For better definition of the actual benefit of coronary intervention after resuscitation from cardiac arrest and the optimal target groups, randomized controlled studies on patients with ST-elevation myocardial infarction are desirable, while for other forms of acute coronary syndromes these studies are essential.
authors.affiliation: Interdisziplinäre Rettungsstelle, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Hindenburgdamm 30, 12200, Berlin, Deutschland. hrarntz@t-online.de.
authors.forename: Hans-Richard
authors.initials: HR
authors.lastname: Arntz
authors.affiliation: Klinik für Kardiologie und Pulmologie, Campus Benjamin Franklin, Charité, Universitätsmedizin Berlin, Berlin, Deutschland.
authors.forename: Hans-Christian
authors.initials: HC
authors.lastname: Mochmann
mesh_terms: D054058:Acute Coronary Syndrome / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016757:Death, Sudden, Cardiac / Q000209:etiology / Q000517:prevention & control*; D004632:Emergency Medical Services / Q000379:methods; D019317:Evidence-Based Medicine; D005858:Germany; D006801:Humans; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D012151:Resuscitation / Q000379:methods*; D000072657:ST Elevation Myocardial Infarction / Q000150:complications / Q000175:diagnosis / Q000601:surgery*; D016896:Treatment Outcome
keywords: Coronary angiography; Coronary syndromes, acute; Electrocardiography; ST-elevation myocardial infarction; Spontaneous circulation