Out-of-Hospital Cardiac Arrest Survivors Without ST-Segment Elevation had Lower Coronary Artery Stenosis in an Asian Population.

Abstract

Objectives: Guidelines recommend emergent coronary angiography (CAG) for out-of-hospital cardiac arrest (OHCA) patients with ST-segment elevation (STE) and selective angiography for those without STE. However, real-world data reporting coronary artery status in OHCA patients without STE are scarce, especially in an Asian population. This study evaluated the coronary artery status and associated outcomes in Asian OHCA patients without STE, comparing the results with those of patients with STE.

Methods: This retrospective study enrolled 345 OHCA survivors with presumed cardiogenic cause who underwent CAG. Based on electrocardiographic evidence of STE following return of spontaneous circulation, the patients were segmented into an STE group (n = 150) and a non-STE group (n = 195). The CAG findings and percutaneous intervention details for the non-STE group were compared with those of the STE group. Chi-squared tests were applied for categorical variables, whereas Mann-Whitney U tests were applied for continuous variables.

Results: Compared with the STE group, the non-STE group had a lower but still high prevalence of coronary artery stenosis (69.7% vs 91.3%, P < .001) and multivessel involvement (50.8% vs 68.0%, P = .001), especially in the left anterior descending coronary artery (56.9% vs 79.3%, P < .001). No differences in survival-to-discharge and neurological outcomes were observed.

Conclusion: In OHCA survivors with presumed acute coronary syndrome, there was a high prevalence of coronary artery stenosis and multivessel involvement in patients without STE. Moreover, patients without STE had comparable survival-to-discharge and neurological outcomes with patients with STE.