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2015 ; 56
(4
): 887-94
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Combined ECG, Echocardiographic, and Biomarker Criteria for Diagnosing Acute
Myocardial Infarction in Out-of-Hospital Cardiac Arrest Patients
#MMPMID26069108
Lee SE
; Uhm JS
; Kim JY
; Pak HN
; Lee MH
; Joung B
Yonsei Med J
2015[Jul]; 56
(4
): 887-94
PMID26069108
show ga
PURPOSE: Acute coronary lesions commonly trigger out-of-hospital cardiac arrest
(OHCA). However, the prevalence of coronary artery disease (CAD) in Asian
patients with OHCA and whether electrocardiogram (ECG) and other findings might
predict acute myocardial infarction (AMI) have not been fully elucidated.
MATERIALS AND METHODS: Of 284 consecutive resuscitated OHCA patients seen between
January 2006 and July 2013, we enrolled 135 patients who had undergone coronary
evaluation. ECGs, echocardiography, and biomarkers were compared between patients
with or without CAD. RESULTS: We included 135 consecutive patients aged 54 years
(interquartile range 45-65) with sustained return of spontaneous circulation
after OHCA between 2006 and 2012. Sixty six (45%) patients had CAD. The initial
rhythm was shockable and non-shockable in 110 (81%) and 25 (19%) patients,
respectively. ST-segment elevation predicted CAD with 42% sensitivity, 87%
specificity, and 65% accuracy. ST elevation and/or regional wall motion
abnormality (RWMA) showed 68% sensitivity, 52% specificity, and 70% accuracy in
the prediction of CAD. Finally, a combination of ST elevation and/or RWMA and/or
troponin T elevation predicted CAD with 94% sensitivity, 17% specificity, and 55%
accuracy. CONCLUSION: In patients with OHCA without obvious non-cardiac causes,
selection for coronary angiogram based on the combined criterion could detect 94%
of CADs. However, compared with ECG only criteria, the combined criterion failed
to improve diagnostic accuracy with a lower specificity.