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Should we perform a coronary angiography in all cardiac arrest survivors?

Geri, Guillaumea,c,d; Dumas, Florenceb,c,d; Cariou, Alaina,c,d

Current Opinion in Critical Care: June 2014 - Volume 20 - Issue 3 - p 273–279
doi: 10.1097/MCC.0000000000000093
CARDIOPULMONARY RESUSCITATION: Edited by Fabio S. Taccone

Purpose of review: Percutaneous coronary revascularization is the cornerstone treatment of acute coronary syndromes. Out-of-hospital cardiac arrest (OHCA) is in most cases related to a culprit coronary occlusion and should be treated as soon as possible.

Recent findings: To date, no biomarker has been evidenced to correctly predict culprit coronary occlusion in OHCA patients in order to select the best candidates for coronary angiography after OHCA. Moreover, successful percutaneous coronary intervention has been associated with better ICU and long-term survival in such patients. Although all these data are provided by retrospective studies, results can be considered strong enough to support systematic coronary angiography after OHCA. Taken together, these findings strongly suggest the necessity to systematically perform coronary angiography after no obvious noncardiac cause of OHCA.

Summary: Systematic percutaneous coronary intervention after no obvious noncardiac cause of OHCA appears to be the most secure and the best adapted in these patients.

aMedical Intensive Care Unit

bEmergency Department, Cochin Hospital, Assistance Publique-Hôpitaux de Paris

cParis Descartes University

dSudden Death Expertise Centre, Paris Cardiovascular Research Centre, INSERM U970 (team 4), Paris, France

Correspondence to Alain Cariou, Medical Intensive Care Unit, Cochin Hospital, AP-HP, 27 rue du Faubourg Saint Jacques, 75014 Paris, France. Tel: +33 1 58 41 25 01; fax: +33 1 58 41 25 05; e-mail: alain.cariou@cch.aphp.fr

© 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins