ΓΕΡΑΣΙΜΟΣ ΓΑΒΡΙΕΛΑΤΟΣ
Καρδιολογική Κλινική, ΓΝΑ “Η ΕΛΠΙΣ”
KΩΝΣΤΑΝΤΙΝΟΣ ΓΡΗΓΟΡΙΟΥ
Καρδιολογική Κλινική, ΓΝΑ “Η ΕΛΠΙΣ”
ΓΕΩΡΓΙΟΣ ΜΙΧΑΣ
Καρδιολογική Κλινική, ΓΝΑ “Η ΕΛΠΙΣ”
ΑΘΑΝΑΣΙΟΣ ΤΡΙΚΑΣ
Καρδιολογική Κλινική, ΓΝΑ “Η ΕΛΠΙΣ”
Περίληψη
Out-of-hospital cardiac arrest (OHCA) remains a common cause of death, afflicting over 347000 patients per year in the United States. Despite efforts to increase awareness and training of the general population, outcomes remain poor with in hospital survival rates between 1% and 33%, in several reports. There has been increased recognition of the importance of post–cardiac arrest care after return of spontaneous circulation (ROSC). Early coronary angiography in survivors of OHCA reveals clinically significant coronary artery disease in 70% of patients and acute coronary artery occlusion in almost 50% of patients. Coronary revascularization has been proven beneficial for patients with ST elevation myocardial infarction on their ECG after ROSC. However, it is clinically difficult to decide if and when to perform coronary angiography in patients resuscitated from OHCA who remain comatose and do not have a current consistent with injury on their post-arrest ECG. In the present review we obtained the most recent current literature in relevant electronic databases (Medline, Google Scholar, Scopus etch.) to provide practical recommendations, on selection strategy of OHCA survivors for immediate coronary angiography and PCI, the proper medical therapy and the possible role of adjunctive therapies like targeted temperature management.
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