title: The association of maximum Troponin values post out-of-hospital cardiac arrest with electrocardiographic findings, cardiac reperfusion procedures and survival to discharge: A sub-study of ROC PRIMED.
abstract: The role of Troponin (Tn) levels in the management of patients post out-of-hospital cardiac arrest (OHCA) is unclear.
  
  
  
  All OHCA patients enrolled in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis trial and admitted to hospital with a Tn level and a 12-lead electrocardiogram were stratified by ST elevation (STE) or no STE in a regression model for survival to discharge adjusted for Utstein predictors and site.
  
  
  
  Of the 15,617 enrolled OHCA patients, 4118 (26%) survived to admission to hospital; 17% (693) were STE and 77% (3188) were no STE with 6% unknown; 83% (3460) had at least one Tn level. Reperfusion rates were higher when Tn level >2ng/ml (p>0.1ng/ml) improved with a diagnostic cardiac catheterization (p<0.001).
  
  
  
  Elevated Tn levels >2ng/ml were associated with improved survival to discharge in patients post OHCA with STE. Survival in patients with no STE and Tn values >0.1ng/ml was higher when associated with diagnostic cardiac catheterization or treated with reperfusion or revascularization.
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Division of Emergency Medicine, Department of Medicine, University of Toronto, 30 Bond Street, Toronto, Ontario M5B 1W8, Canada. Electronic address: morrisonl@smh.ca.
authors.forename: Laurie J
authors.initials: LJ
authors.lastname: Morrison
authors.affiliation: Department of Epidemiology and Biostatistics, Memorial Sloan-Kettering Cancer Center, 307 East 63rd Street, 3rd Floor, New York, NY, United States. Electronic address: sedevlin@gmail.com.
authors.forename: Sean M
authors.initials: SM
authors.lastname: Devlin
authors.affiliation: Pauley Heart Center, Division of Cardiology, Virginia Commonwealth University, Richmond, VA, United States. Electronic address: mkontos@mcvh-vcu.edu.
authors.forename: Michael C
authors.initials: MC
authors.lastname: Kontos
authors.affiliation: Rescu, Li Ka Shing Knowledge Institute, St Michael's Hospital, Sunnybrook Centre for Prehospital Medicine, Division of Emergency Medicine, Department of Family and Community Medicine University of Toronto, 77 Browns Line, Suite 100, Toronto, Ontario M8W 3S2, Canada. Electronic address: Sheldon.Cheskes@sunnybrook.ca.
authors.forename: Sheldon
authors.initials: S
authors.lastname: Cheskes
authors.affiliation: Medical College of Wisconsin, Department of Emergency Medicine, 9200 W. Wisconsin Avenue, Pavilion 1P, Milwaukee, WI 53226, United States. Electronic address: TAufderh@mcw.edu.
authors.forename: Tom P
authors.initials: TP
authors.lastname: Aufderheide
authors.affiliation: University of British Columbia, Department of Emergency Medicine, Room 3300 3rd Floor, 910 West 10th Avenue, Vancouver, British Columbia V5Z 1M9, Canada. Electronic address: jim.christenson@ubc.ca.
authors.forename: Jim
authors.initials: J
authors.lastname: Christenson
authors.affiliation: Department of Emergency Medicine, Virginia Commonwealth University, Richmond, VA, United States. Electronic address: ornato@aol.com.
authors.forename: Joseph P
authors.initials: JP
authors.lastname: Ornato
authors.affiliation: Department of Emergency Medicine, Ottawa Hospital Research Institute, University of Ottawa, Clinical Epidemiology Unit, F6 1053 Carling Avenue, Ottawa, Ontario K1Y 4E9, Canada. Electronic address: istiell@ohri.ca.
authors.forename: Ian G
authors.initials: IG
authors.lastname: Stiell
authors.affiliation: THETA (Toronto Health Economics and Technology Assessment) Collaborative, Toronto General Research Institute, University Health Network and Leslie Dan Pharmacy Building, 6th Floor, Room 651, 144 College Street, Toronto, Ontario M5S 3M2, Canada. Electronic address: valeria.rac@theta.utoronto.ca.
authors.forename: Valeria E
authors.initials: VE
authors.lastname: Rac
authors.affiliation: School of Medicine, Oregon Health & Science University, 3181 SW Sam Jackson Park Rd, Portland, OR 97239-3098, United States. Electronic address: thomandr@ohsu.edu.
authors.forename: Andrew J
authors.initials: AJ
authors.lastname: Thomas
authors.affiliation: University of Texas Southwestern Medical Center, 5323 Harry Hines Boulevard, Dallas, TX 75390, United States. Electronic address: jane.wigginton@utsw.edu.
authors.forename: Jane G
authors.initials: JG
authors.lastname: Wigginton
authors.affiliation: Division of Cardiology, Department of Medicine, St Michael's Hospital and University of Toronto, Toronto, Ontario, Canada. Electronic address: DORIANP@smh.ca.
authors.forename: Paul
authors.initials: P
authors.lastname: Dorian
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization; D016887:Cardiopulmonary Resuscitation; D004562:Electrocardiography; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058687:Out-of-Hospital Cardiac Arrest / Q000097:blood / Q000401:mortality / Q000503:physiopathology* / Q000628:therapy*; D015424:Reperfusion; D014336:Troponin / Q000097:blood*
chemical_list: D014336:Troponin
keywords: Angiography; Cardiopulmonary resuscitation; Fibrinolysis; Heart arrest; Thrombolysis