Department of Medicine III (Interdisciplinary Medical Intensive Care), Freiburg Medical Center, Faculty of Medicine, University of Freiburg, Freiburg, Germany.
Department of Cardiology and Angiology I, Heart Center, University of Freiburg, Freiburg, Germany.
Expert Rev Cardiovasc Ther. 2021 Dec;19(12):1045-1051. doi: 10.1080/14779072.2021.2013815. Epub 2021 Dec 15.
In patients suffering a sudden out-of-hospital cardiac arrest (OHCA), the prevalence of a coronary artery lesion as the underlying cause is relatively high, but many other causes have been described. For this reason, identifying patients who would benefit from an emergency coronary angiography is important.
In the present manuscript, we reviewed the literature covering some relevant studies regarding the role of coronary angiography in patients with OHCA, including our local algorithm for the management of patients with OHCA. We particularly focused on the selection of patients who would benefit from an emergency coronary angiography, the time period until the performance of the angiography, the role of extracorporeal cardiopulmonary resuscitation (ECPR), the identification of a coronary artery lesion as the underlying cause of cardiac arrest and clinical outcomes.
In summary, a local standard algorithm for the management of patients with OHCA appears favorable. An emergency coronary angiography should be advised in patients with a presumed cardiac cause and without obvious non-cardiac cause. A shockable initial rhythm, ST elevation in the post-resuscitation ECG, a previously known coronary artery disease, and ECPR are important predictors of cardiac cause of OHCA.
在突发院外心脏骤停（OHCA）的患者中，冠状动脉病变作为潜在病因的患病率相对较高，但也有许多其他病因已被描述。因此，确定哪些患者将从紧急冠状动脉造影中获益非常重要。
在本手稿中，我们复习了涵盖一些相关研究的文献，这些研究涉及 OHCA 患者的冠状动脉造影作用，包括我们对 OHCA 患者管理的本地算法。我们特别关注那些将从紧急冠状动脉造影中获益的患者的选择、进行血管造影的时间、体外心肺复苏（ECPR）的作用、识别冠状动脉病变作为心脏骤停的潜在病因以及临床结果。
总之，OHCA 患者的本地标准算法似乎是有利的。对于疑似心脏原因且无明显非心脏原因的患者，应建议进行紧急冠状动脉造影。初始可电击节律、复苏后心电图中的 ST 段抬高、先前已知的冠状动脉疾病和 ECPR 是 OHCA 心脏原因的重要预测因素。
