Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest

Clifton W. Callaway, Robert H. Schmicker, Siobhan P. Brown, J. Michael Albrich, Douglas L. Andrusiek, Tom P. Aufderheide, James Christenson, Mohamud Ramzan Daya, David Falconer, Ruchika D. Husa, Ahamed H. Idris, Joseph P. Ornato, Valeria E. Rac, Thomas D. Rea, Jon C. Rittenberger, Gena Sears, Ian G. Stiell

Research output: Contribution to journalArticle

101 Citations (Scopus)

Abstract

Background: The rate and effect of coronary interventions and induced hypothermia after out-of-hospital cardiac arrest (OHCA) are unknown. We measured the association of early (≤24. h after arrival) coronary angiography, reperfusion, and induced hypothermia with favorable outcome after OHCA. Methods: We performed a secondary analysis of a multicenter clinical trial (NCT00394706) conducted between 2007 and 2009 in 10 North American regions. Subjects were adults (≥18 years) hospitalized after OHCA with pulses sustained ≥60. min. We measured the association of early coronary catheterization, percutaneous coronary intervention, fibrinolysis, and induced hypothermia with survival to hospital discharge with favorable functional status (modified Rankin Score. ≤. 3). Results: From 16,875 OHCA subjects, 3981 (23.6%) arrived at 151 hospitals with sustained pulses. 1317 (33.1%) survived to hospital discharge, with 1006 (25.3%) favorable outcomes. Rates of early coronary catheterization (19.2%), coronary reperfusion (17.7%) or induced hypothermia (39.3%) varied among hospitals, and were higher in hospitals treating more subjects per year. Odds of survival and favorable outcome increased with hospital volume (per 5 subjects/year OR 1.06; 95%CI: 1.04-1.08 and OR 1.06; 95%CI: 1.04, 1.08, respectively). Survival and favorable outcome were independently associated with early coronary angiography (OR 1.69; 95%CI 1.06-2.70 and OR 1.87; 95%CI 1.15-3.04), coronary reperfusion (OR 1.94; 95%CI 1.34-2.82 and OR 2.14; 95%CI 1.46-3.14), and induced hypothermia (OR 1.36; 95%CI 1.01-1.83 and OR 1.42; 95%CI 1.04-1.94). Interpretation: : Early coronary intervention and induced hypothermia are associated with favorable outcome and are more frequent in hospitals that treat higher numbers of OHCA subjects per year.

Original languageEnglish (US)
Pages (from-to)657-663
Number of pages7
JournalResuscitation
Volume85
Issue number5
DOIs
StatePublished - 2014

Fingerprint

Out-of-Hospital Cardiac Arrest
Induced Hypothermia
Coronary Angiography
Myocardial Reperfusion
Catheterization
Fibrinolysis
Percutaneous Coronary Intervention
Multicenter Studies
Clinical Trials

Keywords

  • Coronary angiography
  • Fibrinolysis
  • Heart arrest
  • Hypothermia
  • Percutaneous coronary intervention

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Emergency
  • Emergency Medicine
  • Medicine(all)

Cite this

Callaway, C. W., Schmicker, R. H., Brown, S. P., Albrich, J. M., Andrusiek, D. L., Aufderheide, T. P., ... Stiell, I. G. (2014). Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. Resuscitation, 85(5), 657-663. https://doi.org/10.1016/j.resuscitation.2013.12.028

Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. / Callaway, Clifton W.; Schmicker, Robert H.; Brown, Siobhan P.; Albrich, J. Michael; Andrusiek, Douglas L.; Aufderheide, Tom P.; Christenson, James; Daya, Mohamud Ramzan; Falconer, David; Husa, Ruchika D.; Idris, Ahamed H.; Ornato, Joseph P.; Rac, Valeria E.; Rea, Thomas D.; Rittenberger, Jon C.; Sears, Gena; Stiell, Ian G.

In: Resuscitation, Vol. 85, No. 5, 2014, p. 657-663.

Research output: Contribution to journalArticle

Callaway, CW, Schmicker, RH, Brown, SP, Albrich, JM, Andrusiek, DL, Aufderheide, TP, Christenson, J, Daya, MR, Falconer, D, Husa, RD, Idris, AH, Ornato, JP, Rac, VE, Rea, TD, Rittenberger, JC, Sears, G & Stiell, IG 2014, 'Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest', Resuscitation, vol. 85, no. 5, pp. 657-663. https://doi.org/10.1016/j.resuscitation.2013.12.028
Callaway, Clifton W. ; Schmicker, Robert H. ; Brown, Siobhan P. ; Albrich, J. Michael ; Andrusiek, Douglas L. ; Aufderheide, Tom P. ; Christenson, James ; Daya, Mohamud Ramzan ; Falconer, David ; Husa, Ruchika D. ; Idris, Ahamed H. ; Ornato, Joseph P. ; Rac, Valeria E. ; Rea, Thomas D. ; Rittenberger, Jon C. ; Sears, Gena ; Stiell, Ian G. / Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest. In: Resuscitation. 2014 ; Vol. 85, No. 5. pp. 657-663.
@article{55119e6538b7476491c8cbf6a878f7e2,
title = "Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest",
abstract = "Background: The rate and effect of coronary interventions and induced hypothermia after out-of-hospital cardiac arrest (OHCA) are unknown. We measured the association of early (≤24. h after arrival) coronary angiography, reperfusion, and induced hypothermia with favorable outcome after OHCA. Methods: We performed a secondary analysis of a multicenter clinical trial (NCT00394706) conducted between 2007 and 2009 in 10 North American regions. Subjects were adults (≥18 years) hospitalized after OHCA with pulses sustained ≥60. min. We measured the association of early coronary catheterization, percutaneous coronary intervention, fibrinolysis, and induced hypothermia with survival to hospital discharge with favorable functional status (modified Rankin Score. ≤. 3). Results: From 16,875 OHCA subjects, 3981 (23.6{\%}) arrived at 151 hospitals with sustained pulses. 1317 (33.1{\%}) survived to hospital discharge, with 1006 (25.3{\%}) favorable outcomes. Rates of early coronary catheterization (19.2{\%}), coronary reperfusion (17.7{\%}) or induced hypothermia (39.3{\%}) varied among hospitals, and were higher in hospitals treating more subjects per year. Odds of survival and favorable outcome increased with hospital volume (per 5 subjects/year OR 1.06; 95{\%}CI: 1.04-1.08 and OR 1.06; 95{\%}CI: 1.04, 1.08, respectively). Survival and favorable outcome were independently associated with early coronary angiography (OR 1.69; 95{\%}CI 1.06-2.70 and OR 1.87; 95{\%}CI 1.15-3.04), coronary reperfusion (OR 1.94; 95{\%}CI 1.34-2.82 and OR 2.14; 95{\%}CI 1.46-3.14), and induced hypothermia (OR 1.36; 95{\%}CI 1.01-1.83 and OR 1.42; 95{\%}CI 1.04-1.94). Interpretation: : Early coronary intervention and induced hypothermia are associated with favorable outcome and are more frequent in hospitals that treat higher numbers of OHCA subjects per year.",
keywords = "Coronary angiography, Fibrinolysis, Heart arrest, Hypothermia, Percutaneous coronary intervention",
author = "Callaway, {Clifton W.} and Schmicker, {Robert H.} and Brown, {Siobhan P.} and Albrich, {J. Michael} and Andrusiek, {Douglas L.} and Aufderheide, {Tom P.} and James Christenson and Daya, {Mohamud Ramzan} and David Falconer and Husa, {Ruchika D.} and Idris, {Ahamed H.} and Ornato, {Joseph P.} and Rac, {Valeria E.} and Rea, {Thomas D.} and Rittenberger, {Jon C.} and Gena Sears and Stiell, {Ian G.}",
year = "2014",
doi = "10.1016/j.resuscitation.2013.12.028",
language = "English (US)",
volume = "85",
pages = "657--663",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",
number = "5",

}

TY - JOUR

T1 - Early coronary angiography and induced hypothermia are associated with survival and functional recovery after out-of-hospital cardiac arrest

AU - Callaway, Clifton W.

AU - Schmicker, Robert H.

AU - Brown, Siobhan P.

AU - Albrich, J. Michael

AU - Andrusiek, Douglas L.

AU - Aufderheide, Tom P.

AU - Christenson, James

AU - Daya, Mohamud Ramzan

AU - Falconer, David

AU - Husa, Ruchika D.

AU - Idris, Ahamed H.

AU - Ornato, Joseph P.

AU - Rac, Valeria E.

AU - Rea, Thomas D.

AU - Rittenberger, Jon C.

AU - Sears, Gena

AU - Stiell, Ian G.

PY - 2014

Y1 - 2014

N2 - Background: The rate and effect of coronary interventions and induced hypothermia after out-of-hospital cardiac arrest (OHCA) are unknown. We measured the association of early (≤24. h after arrival) coronary angiography, reperfusion, and induced hypothermia with favorable outcome after OHCA. Methods: We performed a secondary analysis of a multicenter clinical trial (NCT00394706) conducted between 2007 and 2009 in 10 North American regions. Subjects were adults (≥18 years) hospitalized after OHCA with pulses sustained ≥60. min. We measured the association of early coronary catheterization, percutaneous coronary intervention, fibrinolysis, and induced hypothermia with survival to hospital discharge with favorable functional status (modified Rankin Score. ≤. 3). Results: From 16,875 OHCA subjects, 3981 (23.6%) arrived at 151 hospitals with sustained pulses. 1317 (33.1%) survived to hospital discharge, with 1006 (25.3%) favorable outcomes. Rates of early coronary catheterization (19.2%), coronary reperfusion (17.7%) or induced hypothermia (39.3%) varied among hospitals, and were higher in hospitals treating more subjects per year. Odds of survival and favorable outcome increased with hospital volume (per 5 subjects/year OR 1.06; 95%CI: 1.04-1.08 and OR 1.06; 95%CI: 1.04, 1.08, respectively). Survival and favorable outcome were independently associated with early coronary angiography (OR 1.69; 95%CI 1.06-2.70 and OR 1.87; 95%CI 1.15-3.04), coronary reperfusion (OR 1.94; 95%CI 1.34-2.82 and OR 2.14; 95%CI 1.46-3.14), and induced hypothermia (OR 1.36; 95%CI 1.01-1.83 and OR 1.42; 95%CI 1.04-1.94). Interpretation: : Early coronary intervention and induced hypothermia are associated with favorable outcome and are more frequent in hospitals that treat higher numbers of OHCA subjects per year.

AB - Background: The rate and effect of coronary interventions and induced hypothermia after out-of-hospital cardiac arrest (OHCA) are unknown. We measured the association of early (≤24. h after arrival) coronary angiography, reperfusion, and induced hypothermia with favorable outcome after OHCA. Methods: We performed a secondary analysis of a multicenter clinical trial (NCT00394706) conducted between 2007 and 2009 in 10 North American regions. Subjects were adults (≥18 years) hospitalized after OHCA with pulses sustained ≥60. min. We measured the association of early coronary catheterization, percutaneous coronary intervention, fibrinolysis, and induced hypothermia with survival to hospital discharge with favorable functional status (modified Rankin Score. ≤. 3). Results: From 16,875 OHCA subjects, 3981 (23.6%) arrived at 151 hospitals with sustained pulses. 1317 (33.1%) survived to hospital discharge, with 1006 (25.3%) favorable outcomes. Rates of early coronary catheterization (19.2%), coronary reperfusion (17.7%) or induced hypothermia (39.3%) varied among hospitals, and were higher in hospitals treating more subjects per year. Odds of survival and favorable outcome increased with hospital volume (per 5 subjects/year OR 1.06; 95%CI: 1.04-1.08 and OR 1.06; 95%CI: 1.04, 1.08, respectively). Survival and favorable outcome were independently associated with early coronary angiography (OR 1.69; 95%CI 1.06-2.70 and OR 1.87; 95%CI 1.15-3.04), coronary reperfusion (OR 1.94; 95%CI 1.34-2.82 and OR 2.14; 95%CI 1.46-3.14), and induced hypothermia (OR 1.36; 95%CI 1.01-1.83 and OR 1.42; 95%CI 1.04-1.94). Interpretation: : Early coronary intervention and induced hypothermia are associated with favorable outcome and are more frequent in hospitals that treat higher numbers of OHCA subjects per year.

KW - Coronary angiography

KW - Fibrinolysis

KW - Heart arrest

KW - Hypothermia

KW - Percutaneous coronary intervention

UR - http://www.scopus.com/inward/record.url?scp=84898419078&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84898419078&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2013.12.028

DO - 10.1016/j.resuscitation.2013.12.028

M3 - Article

VL - 85

SP - 657

EP - 663

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

IS - 5

ER -