20.500.12556/RUL-159157 Coronary features across the spectrum of out-of-hospital cardiac arrest with ST-elevation myocardial infarction (CAD-OHCA study) Aim: We hypothesized that adult patients with out-of-hospital cardiac arrest (OHCA) and ST-elevation myocardial infarction (STEMI) requiring prolonged resuscitation have more severe coronary artery disease (CAD) than those responding rapidly, and more severe CAD than patients with STEMI without OHCA. Methods: Consecutive conscious and comatose OHCA patients with STEMI after reestablishment of spontaneous circulation (ROSC), and patients with refractory OHCA undergoing veno-arterial extracorporeal membrane oxygenation (E-CPR OHCA) were compared to STEMI without OHCA (STEMI no OHCA). CAD severity was assessed by a single physician blinded to the resuscitation method, time to ROSC and level of consciousness. Results: Between 2016 and 2022, 71 conscious OHCA, 157 comatose OHCA, 50 E-CPR OHCA and 101 STEMI no OHCA underwent immediate coronary angiography. Acute culprit lesion was documented less often in OHCA (88.1% vs 97%; p = 0.009) but complete occlusion was more frequent (68.8% vs 58.4%; p = 0.038) than in STEMI no OHCA. SYNTAX score was 5.6 in STEMI no OHCA, 10.2 in conscious OHCA, 13.4 in comatose OHCA and 26.8 in E-CPR OHCA (p < 0.001). There was a linear correlation between SYNTAX score and delay to ROSC/ECMO initiation (r$^2$ = 0.61; p < 0.001). Post PCI culprit TIMI 3 flow was comparable between the groups (≥86%). SYNTAX score was among independent predictors of 5-year survival which was significantly decreased in comatose OHCA (56.1%) and E-CPR OHCA (36.0%) compared to conscious OHCA (83.1%) and STEMI no OHCA (88.1%). Conclusion: Compared to STEMI no OHCA, OHCA was associated with increased incidence of acute coronary occlusion and more complex non culprit CAD which progressively increased from conscious OHCA to E-CPR OHCA. Severity of CAD was associated with increased delays to ROSC/ECMO initiation and decreased long term survival. out-of-hospital cardiac arrest coronary angiography E-CPR chest compression srčni zastoj zunaj bolnišnice koronarna angiografija E-CPR true false true Angleški jezik Slovenski jezik Članek v reviji 2024-07-02 11:41:01 2024-07-02 11:41:02 2024-07-13 03:25:58 0000-00-00 00:00:00 2023 0 0 7 str. art. 109981 Vol. 193 2023 0000-00-00 Zaloznikova Objavljeno NiDoloceno 0000-00-00 0000-00-00 0000-00-00 0300-9572 10.1016/j.resuscitation.2023.109981 201651459 1-s2.0-S0300957223002952-main.pdf 1-s2.0-S0300957223002952-main.pdf 1 C04691DD0D4340FA271E91A7C0BD3846 a92ace3a16a0d19354f0474be2cbaef82456573440922a249ba77c051429c35a d8a5e872-3857-11ef-926e-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=187089 https://www.sciencedirect.com/science/article/pii/S0300957223002952 0 bbe70179-3857-11ef-926e-0050569b8976 https://repozitorij.uni-lj.si/Dokument.php?lang=slv&id=187088 Medicinska fakulteta 0 0 0