Post-resuscitation electrocardiograms, acute coronary findings and in-hospital prognosis of survivors of out-of-hospital cardiac arrest

Abstract Background Identification of acute coronary lesions amenable to urgent intervention in survivors of out-of-hospital cardiac arrest is crucial. We aimed to compare the clinical and electrocardiographic characteristics to urgent coronary findings, and to analyze in-hospital prognosis of these patients. Methods From January 2005 to December 2012 we retrospectively identified consecutive patients resuscitated from out-of-hospital cardiac arrest, and analyzed the clinical characteristics, post-resuscitation electrocardiogram and coronary angiogram of those who underwent emergent angiography. Mortality and neurologic status at discharge were also assessed. Results Patients with ST-elevation more frequently had obstructive coronary artery disease (89% vs. 51%, p p p  = 0.01), a shockable initial rhythm (OR 0.16, 95% CI 0.03–0.9, p  = 0.03), and ST-elevation on the post-resuscitation electrocardiogram (OR 0.02, 95% CI 0.004–0.13, p p  = 0.04), prolonged resuscitation time (OR 0.9, 95% CI 0.8–0.9, p  = 0.01), and necessity of vasopressors (OR 14.8, 95% CI 3.3–65.4, p  = 0.001). Conclusions Most patients with ST-elevation on the post-resuscitation electrocardiogram had an acute coronary occlusion, as opposed to patients without ST-elevation. Absence of basic life support, prolonged resuscitation time and use of vasopressors were independent predictors of worse in-hospital outcome.