Improved Outcomes in Survivors of Cardiac Arrest Qualified for Early Coronary Angiography: A Single Tertiary Center Study

Introduction: Most cardiac arrests in adults are related to coronary artery disease (CAD), and the role of early invasive cardiology procedures remains unclear.

Aims: We investigated the prognosis for patients hospitalized for out-of-hospital cardiac arrest (OHCA) or in-hospital cardiac arrest (IHCA) who were referred within 24 hours to a tertiary cardiology department, with a focus on the role of early coronary angiography (CA) and percutaneous coronary intervention (PCI).

Methods: This was an observational, single-center study using retrospective and prospective cohorts. Consecutive patients hospitalized for OHCA or IHCA and referred within 24 hours to a cardiology department were included in the study. Survival until hospital discharge was the primary outcome.

Results: One hundred and forty-eight patients aged 71 (14) years were included, 68 hospitalized for OHCA, and 80 patients after IHCA. Overall, in-hospital survival in the study group was 45% (66/148). In a multivariable logistic regression model, independent predictors of death were ejection fraction (EF) ≤30% (odds ratio [OR], 4.1; 95% confidence interval [CI], 1.69-10.03), blood oxygen saturation (SpO₂) ≤90% (OR, 2.77; 95% CI, 1.19-6.46), non-ST-segement elevation myocardial infarction (NSTEMI) (OR, 2.71; 95% CI, 1.02-7.21). The risk of death was lower in patients who underwent early CA (OR, 0.28; 95% CI, 0.1-0.74) or received at least one defibrillation (OR, 0.11; 95% CI, 0.05-0.27), even after adjustment for other factors.

Conclusions: In this series from a tertiary cardiac center, patients who underwent early CA had improved outcomes after cardiac arrest. In the multivariable logistic regression model, lower SpO₂, lower EF, and NSTEMI were independent risk factors of death, whereas early CA and initial shockable rhythm improved survival.