Angiographic characteristics and long-term prognostic impact of coronary artery disease in survivors after sudden cardiac arrest with a non-diagnostic electrocardiogram

Catheter Cardiovasc Interv. 2019 Jan 1;93(1):9-15. doi: 10.1002/ccd.27713. Epub 2018 Oct 2.

Abstract

Objectives: Our purpose was to describe the prevalence, distribution, extension, and prognostic value of coronary artery disease (CAD) in patients resuscitated from sudden cardiac arrest (SCA) with non-diagnostic electrocardiogram (ECG).

Background: The impact of CAD and the indication for cardiac catheterization (CC) in patients resuscitated from SCA with non-diagnostic ECG are uncertain.

Methods: We included prospectively and consecutively 545 patients resuscitated from SCA with at least one CC during hospitalization. From them, 203 patients with a non-diagnostic ECG formed our study population. Patients were followed-up 5 years after discharge.

Results: Overall, 125 (61.6%) patients had significant CAD, and at least one acute culprit lesion was found in 25 (12.4%). Regarding the burden and complexity of CAD, 78 (38.4%) patients had a CAD Prognostic Index of 0 and a SYNTAX score of 0. There was higher 5-year mortality only in patients with very high burden of CAD: three vessels with severe stenosis (P = 0.015) and CAD Prognostic Index Score ≥ 56 (P < 0.001). Tertiles of SYNTAX score did not predict higher 5-year mortality.

Conclusions: In survivors from SCA with a non-diagnostic ECG, significant CAD is highly prevalent. SYNTAX score was not associated with a different long-term prognosis in this patient population. Patients with severe disease in the three main coronary vessels and patients with higher (≥56) CAD Prognostic Index Score had a worse long-term prognosis.

Keywords: ACS/NSTEMI; coronary angiography; coronary artery disease.

Publication types

  • Multicenter Study
  • Observational Study

MeSH terms

  • Aged
  • Coronary Angiography*
  • Coronary Artery Disease / diagnostic imaging*
  • Coronary Artery Disease / mortality
  • Coronary Artery Disease / therapy
  • Databases, Factual
  • Death, Sudden, Cardiac / epidemiology
  • Death, Sudden, Cardiac / prevention & control*
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Predictive Value of Tests
  • Prevalence
  • Prognosis
  • Prospective Studies
  • Resuscitation* / adverse effects
  • Resuscitation* / mortality
  • Risk Assessment
  • Risk Factors
  • Spain / epidemiology
  • Time Factors