https://scholars.lib.ntu.edu.tw/handle/123456789/597684
標題: | Multivessel versus Culprit-Only Revascularization Strategies in Cardiac Arrest Survivors | 作者: | WEI-TING CHEN MIN-SHAN TSAI CHIEN-HUA HUANG CHIH-WEI SUNG Chuang, Po Ya CHIH-HUNG WANG YEN-WEN WU WEI-TIEN CHANG WEN-JONE CHEN |
關鍵字: | Cardiac arrest | Coronary angiography | Multivessel coronary artery disease | Percutaneous coronary intervention | Survival | 公開日期: | 1-三月-2022 | 卷: | 38 | 期: | 2 | 來源出版物: | Acta Cardiologica Sinica | 摘要: | Background: Whether multivessel revascularization or culprit-only revascularization is more beneficial in cardiac arrest survivors with multivessel coronary artery disease remains unclear. We aimed to retrospectively evaluate whether multivessel or culprit-only revascularization following cardiac arrest was associated with a reduced incidence of in-hospital mortality. Methods: A total of 273 adult nontraumatic cardiac arrest survivors (aged ≥ 18 years) who underwent emergent coronary angiography (CAG) within 24 h following cardiac arrest were retrospectively recruited from three hospitals. Patients without definite coronary artery stenosis (n = 72), one-vessel stenosis (n = 74), or failed percutaneous coronary intervention (PCI; n = 37) were excluded. A total of 90 patients were enrolled for the final analysis and classified into multivessel (revascularization of more than one major vessel during the index CAG; n = 45) and culprit-only (revascularization of the infarct-related artery alone; n = 45) groups. Results: Twenty-five patients (55.6%) in the culprit-only group and 17 patients (37.8%) in the multivessel group failed to survive to discharge [adjusted hazard ratio (HR) = 0.47, 95% confidence interval (CI) = 0.24-0.95, p = 0.035]. The benefit of multivessel revascularization on survival was obvious among those with a prolonged cardiopulmonary resuscitation duration (> 10 min) (47.82% vs. 76.92%, adjusted HR = 0.27, 95% CI = 0.08-0.93, p = 0.03). No difference in neurological outcomes (favorable = cerebral performance category scores 1-2; poor = 3-5) between groups was observed (60.0% vs. 55.6%, adjusted OR = 1.22, 95% CI = 0.35-4.26, p = 0.753). Conclusions: Compared with culprit-only revascularization, multivessel revascularization was associated with lower in-hospital mortality among cardiac arrest survivors with multivessel lesions. Owing to the retrospective design and small sample size, the current study should be interpreted as observational and exploratory. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/597684 | ISSN: | 10116842 | DOI: | 10.6515/ACS.202203_38(2).20211107A |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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