Safety and Efficacy of Primary Percutaneous Transluminal Coronary Angioplasty for Acute Myocardial Infarction Complicated by Prolonged Cardiopulmonary Resuscitation

To evaluate the safety and efficacy of primary percutaneous transluminal coronary angioplasty(PTCA) for acute myocardial infarction(AMI) complicated by out-of-hospital cardiac arrest, 10 patients with AMI following prolonged cardiopulmonary resuscitation(CPR) in a period of 5 years were studied. The CPR duration ranged from 10 to 30 minutes. Electrocardiographic evidence of AMI was documented in all patients, with 5 patients in anterior wall and 5 in inferior wall. Peak creatine kinase ranged from 748 to＞10,000 IU/L. Attempted infarct vessel angioplasty was successful in all patients. After angioplasty, the coronary flow was TIMI 3 in all patients. Nine patients survived to hospital discharge. No major complications were found during the angiolpasty procedure. In conclusion, it was feasible and safe to perform primary PTCA for AMI patients with prolonged CPR. Patients with contraindication to thrombolytic therapy may benefit from primary PTCA.