Indications for Cardiac Catheterization and Percutaneous Coronary Intervention in Patients with Resuscitated Out-of-Hospital Cardiac Arrest

• Published in: Current cardiology reports Vol. 25; no. 11; pp. 1523 - 1533
• Main Authors: Sarma, Dhruv, Jentzer, Jacob C.
• Format: Journal Article
• Language: English
• Published: New York Springer US 01.11.2023
• Subjects: Cardiac Catheterization; Cardiology; Cardiopulmonary Resuscitation - adverse effects; Coronary Angiography; Humans; Interventional Cardiology (SR Bailey and T Helmy; Medicine; Medicine & Public Health; Out-of-Hospital Cardiac Arrest - etiology; Out-of-Hospital Cardiac Arrest - therapy; Percutaneous Coronary Intervention - adverse effects; Section Editors; ST Elevation Myocardial Infarction - diagnostic imaging; ST Elevation Myocardial Infarction - surgery; Topical Collection on Interventional Cardiology; Out-of-hospital cardiac arrest; Percutaneous coronary intervention; Post-cardiac arrest care; Cardiogenic shock
• ISSN: 1523-3782; 1534-3170
• DOI: 10.1007/s11886-023-01980-w

Purpose of Review The role of emergent cardiac catheterization after resuscitated out-of-hospital cardiac arrest (OHCA) has evolved based on recent randomized evidence. This review aims to discuss the latest evidence and current indications for emergent coronary angiography (CAG) and mechanical circulatory support (MCS) use following OHCA. Recent Findings In contrast to previous observational data, recent RCTs evaluating early CAG in resuscitated OHCA patients without ST elevation have uniformly demonstrated a lack of benefit in terms of survival or neurological outcome. There is currently no randomized evidence supporting MCS use specifically in patients with resuscitated OHCA and cardiogenic shock. Summary Urgent CAG should be considered in all patients with ST elevation, recurrent electrical or hemodynamic instability, those who are awake following resuscitated OHCA, and those receiving extracorporeal cardiopulmonary resuscitation (ECPR). Recent evidence suggests that CAG may be safely delayed in hemodynamically stable patients without ST-segment elevation following resuscitated OHCA.