Möllmann H, Szardien S, Liebetrau C, Elsässer A, Rixe J, Rolf A, Nef H, Weber M, Hamm C
Department of Cardiology, Kerckhoff Heart and Thorax Centre, Bad Nauheim, Germany.
J Int Med Res. 2011;39(6):2169-77. doi: 10.1177/147323001103900613.
Little is known about the impact of early invasive treatment in patients following out-of-hospital cardiac arrest (OHCA). The present study investigated the clinical characteristics and long-term prognosis of 1254 patients with suspected acute coronary syndrome, including 65 with OHCA who underwent successful cardiopulmonary resuscitation (CPR) and 1189 patients who did not require CRP. All patients underwent immediate coronary angiography even if clear signs of myocardial infarction (MI) were absent. The incidence of ST-elevation and non-ST-elevation MI did not differ between the two groups. Cardiac biomarkers were significantly higher in CPR patients despite a shorter period from symptom onset to admission. The 6-month mortality rate was 29% in the CPR group and 4% in the non-CPR group, with > 90% of fatalities occurring ≤ 3 weeks after admission. In summary, early invasive treatment leads to a considerably reduced mortality and improved prognosis in patients after OHCA.
关于院外心脏骤停(OHCA)患者早期侵入性治疗的影响,目前所知甚少。本研究调查了1254例疑似急性冠状动脉综合征患者的临床特征和长期预后,其中包括65例成功进行心肺复苏(CPR)的OHCA患者和1189例不需要CRP的患者。即使没有明确的心肌梗死(MI)迹象,所有患者均接受了即时冠状动脉造影。两组间ST段抬高型和非ST段抬高型MI的发生率无差异。尽管从症状发作到入院的时间较短,但CPR患者的心脏生物标志物明显更高。CPR组的6个月死亡率为29%,非CPR组为4%,超过90%的死亡发生在入院后≤3周。总之,早期侵入性治疗可显著降低OHCA患者的死亡率并改善预后。