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Clinical Factors Associated with Obstructive Coronary Artery Disease in Patients with Out-of-Hospital Cardiac Arrest: Data from the Korean Cardiac Arrest Research Consortium (KoCARC) Registry

Authors
Park, J | Shin, J | Kim, HL | Song, KJ | Jung, JH | Lee, HJ | You, KM | Lim, WH | Seo, JB | Kim, SH | Zo, JH | Kim, MA | Korean Cardiac Arrest Research Consortium (KoCARC) Investigators  | Korean Cardiac Arrest Research Consortium (KoCARC) Investigators
Citation
Journal of Korean medical science, 34(22). : e159-e159, 2019
Journal Title
Journal of Korean medical science
ISSN
1011-89341598-6357
Abstract
BACKGROUND: Although coronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA), there has been no convinced data on the necessity of routine invasive coronary angiography (ICA) in OHCA. We investigated clinical factors associated with obstructive CAD in OHCA.
METHODS: Data from 516 OHCA patients (mean age 58 years, 83% men) who underwent ICA after resuscitation was obtained from a nation-wide OHCA registry. Obstructive CAD was defined as the lesions with diameter stenosis >/= 50% on ICA. Independent clinical predictors for obstructive CAD were evaluated using multiple logistic regression analysis, and their prediction performance was compared using area under the receiver operating characteristic curve with 10,000 repeated random permutations.
RESULTS: Among study patients, 254 (49%) had obstructive CAD. Those with obstructive CAD were older (61 vs. 55 years, P < 0.001) and had higher prevalence of hypertension (54% vs. 36%, P < 0.001), diabetes mellitus (29% vs. 21%, P = 0.032), positive cardiac enzyme (84% vs. 74%, P = 0.010) and initial shockable rhythm (70% vs. 61%, P = 0.033). In multiple logistic regression analysis, old age (>/= 60 years) (odds ratio [OR], 2.01: 95% confidence interval [CI], 1.36-3.00: P = 0.001), hypertension (OR, 1.74: 95% CI, 1.18-2.57: P = 0.005), positive cardiac enzyme (OR, 1.72: 95% CI, 1.09-2.70: P = 0.019), and initial shockable rhythm (OR, 1.71: 95% CI, 1.16-2.54: P = 0.007) were associated with obstructive CAD. Prediction ability for obstructive CAD increased proportionally when these 4 factors were sequentially combined (P < 0.001).
CONCLUSION: In patients with OHCA, those with old age, hypertension, positive cardiac enzyme and initial shockable rhythm were associated with obstructive CAD. Early ICA should be considered in these patients.
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DOI
10.3346/jkms.2019.34.e159
PMID
31172695
Appears in Collections:
Journal Papers > School of Medicine / Graduate School of Medicine > Emergency Medicine
Ajou Authors
민, 영기  |  박, 은정
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