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1 "coronary stenosis"
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Original Article
CPR/Resuscitation
Is two-dimensional echocardiography better than electrocardiography for predicting patient outcomes after cardiac arrest?
Dong Ki Kim, Yong Soo Cho, Joochan Kim, Byung Kook Lee, Dong Hun Lee, Eujene Jung, Jeong Mi Moon, Byeong Jo Chun
Acute Crit Care. 2021;36(1):37-45.   Published online December 21, 2020
DOI: https://doi.org/10.4266/acc.2020.00773
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  • 1 Web of Science
  • 1 Crossref
AbstractAbstract PDFSupplementary Material
Background
Coronary artery stenosis increases hospital mortality and leads to poor neurological recovery in cardiac arrest (CA) patients. However, electrocardiography (ECG) cannot fully predict the presence of coronary artery stenosis in CA patients. Hence, we aimed to determine whether regional wall motion abnormality (RWMA), as observed by two-dimensional echocardiography (2DE), predicted patient survival outcomes with greater accuracy than did ST segment elevation (STE) on ECG in CA patients who underwent coronary angiography (CAG) after return of spontaneous circulation.
Methods
This was a retrospective observational study of adult patients with CA of presumed cardiac etiology who underwent CAG at a single tertiary care hospital. We investigated whether RWMA observed on 2DE predicted patient outcomes more accurately than did STE observed on ECG. The primary outcome was incidence of hospital mortality. The secondary outcomes were Glasgow-Pittsburgh Cerebral Performance Category scores measured 6 months after discharge and significant coronary artery stenosis on CAG.
Results
Among the 145 patients, 36 (24.8%) experienced in-hospital death. In multivariable analysis of survival outcomes, only total arrest time (P=0.011) and STE (P=0.035) were significant. The odds ratio (OR) and 95% confidence interval (CI), which were obtained by adjusting the total arrest time for survival outcomes, were significant only for STE (OR, 0.40; 95% CI, 0.17–0.94). The presence of RWMA was not a significant factor.
Conclusions
While STE predicted survival outcomes in adult CA patients, RWMA did not. The decision to perform CAG after CA should include ECG under existing guidelines. The use of RWMA has limited benefits in treatment of this population.

Citations

Citations to this article as recorded by  
  • Just the Facts: Management of return of spontaneous circulation after out-of-hospital cardiac arrest
    Hashim Kareemi, Ariel Hendin, Christian Vaillancourt
    Canadian Journal of Emergency Medicine.2023; 25(7): 580.     CrossRef

ACC : Acute and Critical Care