RT Journal Article
SR Electronic
T1 72 Out-of-hospital cardiac arrest survivors undergoing emergency PCI have an excellent neurological recovery
JF Heart
JO Heart
FD BMJ Publishing Group Ltd and British Cardiovascular Society
SP A61
OP A62
DO 10.1136/heartjnl-2019-BCS.70
VO 105
IS Suppl 6
A1 liandra rams ramachenderam
A1 Anthony Mechery
A1 Peter Isherwood
A1 Neil Abeysinghe
A1 Alexander Zaphiriou
A1 Sudhakar George
A1 M. Adnan Nadir
A1 Peter Ludman
A1 Sagar Doshi
A1 Jonathan Townend
A1 sohail khan
YR 2019
UL http://heart.bmj.com/content/105/Suppl_6/A61.abstract
AB Introduction Out-of-hospital cardiac arrest (OHCA) is associated with a low survival to discharge rate. We aimed to evaluate the outcome of early Percutaneous Coronary Intervention (PCI) on the mortality rates of patients with OHCA and their neurological recovery post-intervention.Methods Outcomes of all patients presenting to our centre with OHCA who received PCI over a 3-year period were analysed (January 2015 - December 2017). Univariate analysis was performed.Results 65 patients were identified (80% Males, Mean age 59.9 ± 14.2 years). Chest compressions were undertaken in 60.0% of patients. The most common rhythm identified was Ventricular Fibrillation (86.2%), followed by PEA (9.2%), Ventricular Tachycardia (4.6%) and Asystole (4.6%). The mean time for patients to arrive at the cardiac centre was 51.4± 20.7 minutes. Post-arrest ECG revealed ST-elevation (STEMI) in 53 (81.5%) patients. 42 (64.4%) received ventilation pre-angiography and 45 (69.2%) were transferred to Intensive Care Unit (ITU) post-angiography. 18 (27.7%) were in cardiogenic shock. There was no statistical significance in the mortality rates between patients with STEMI and non-STEMI (53 vs 12; p=0.43), see Table 1. 54 patients (83.1%) survived to discharge, 30-day survival 53(81.6%), 6-month survival 53(81.6%). 31 ventilated patients (73.8%) survived to discharge, 30-days and 6-months whereas all (100%) non-ventilated patients (n=23) survived to discharge and 30-days and 22 survived (95.7%) at 6-months (73.8 vs 100%; p=0.04). 12 patients in shock (66.7%) survived to discharge, 30-days and 6-months whereas 42 non-shocked patients (89.4%) survived to discharge, 30-days and 6-months (66.7 vs 89.4%, p=0.06). Cerebral Performance Category (CPC) score at 30-days was as follows; 48 (73.8%) scored 1, 3 (4.6%) scored 2, 2 (3.1%) scored 3, 1 (1.5%) scored 4 and 11 (16.9%) scored 5. Significantly more patients were in CPC 1 to 3 than 4–5 (53 vs 12; p<0.001), see Table 2.View this table:Abstract 72 Table 1Conclusion In our cohort of patients presenting with OHCA who underwent PCI, we observed an excellent survival to discharge rate. Poor neurological recovery is seen in only a minority of patients who have received PCI after successful OHCA.Conflict of Interest None