0035 : Immediate percutaneous coronary intervention is associated with better survival after out-of-hospital cardiac arrest: experience of Clermont-Ferrand hospital

The out-of-hospital cardiac arrest represent the leading cause of death worldwide. Several therapeutic elements such as early reperfusion developed in recent years to reduce the high morbidity and mortality observed in this situation. The objective of this study was to evaluate the influence of emergency coronary angiography (CAG) and primary percutaneous coronary intervention (PCI) on the outcome of patients survivors after out-of-hospital cardiac arrest. Between January 2012 and June 2013, a total of 54 consecutive patients survivors of out-of-hospital cardiac arrest underwent systematic emergency coronary angiography. Thirty five of the 54 patients had clinically significant coronary disease on angiography, 23 of whom had coronary-artery occlusion (43%). Angioplasty was attempted in 20 patients and was technically successful in 18. The in-hospital survival rate was 48%. Multivariate logistic-regression analysis revealed that angioplasty was an independent predictor of survival (95 percent confidence interval, 3.1 to 750.1; P =0.006). Acute coronary-artery occlusion is frequent in survivors of out-of-hospital cardiac arrest. Accurate diagnosis by immediate coronary angiography can be followed in suitable candidates by coronary angioplasty, which seems to improve survival.