Related Experiment Video
Updated: Jul 5, 2026
Post-Myocardial Infarction Heart Failure in Closed-chest Coronary Occlusion/Reperfusion Model in Göttingen Minipigs and Landrace Pigs
Published on: April 17, 2021
Urgent invasive coronary strategy in patients with sudden cardiac arrest
1Center for Intensive Internal Medicine, University Medical Center, Ljubljana, Slovenia. marko.noc@mf.uni-lj.si
Insights
Urgent coronary angiography and percutaneous coronary intervention improve survival after cardiac arrest. This approach is recommended for conscious patients and selected comatose survivors, especially when mild hypothermia is used.
Area of Science:
- Cardiology
- Emergency Medicine
- Intensive Care Medicine
Background:
- Cardiac arrest survivors often have underlying acute coronary syndromes.
- Timely reperfusion therapy is critical for improving outcomes in these patients.
Purpose of the Study:
- To review evidence on urgent coronary angiography and percutaneous coronary intervention (PCI) after cardiac arrest.
- To assess the feasibility and outcomes of these interventions during cardiocerebral resuscitation.
Main Methods:
- Systematic review of studies on coronary angiography and PCI in post-resuscitation patients.
- Analysis of outcomes including procedural success, survival, and neurological recovery.
Main Results:
- Primary PCI success rate was 89% in ST-elevation myocardial infarction patients post-resuscitation.
- Survival was 57% in comatose survivors, with 38% achieving acceptable neurological outcome.
- PCI was feasible during cardiocerebral resuscitation with an 88% success rate and 41% survival.
Conclusions:
- Urgent coronary angiography and PCI are recommended for conscious post-cardiac arrest patients.
- An urgent invasive strategy is reasonable for comatose survivors with suspected ischemia, facilitated by mild hypothermia.
- PCI can be successful during ongoing resuscitation in selected patients.
Purpose Of Review:
To review the evidence on urgent coronary angiography and percutaneous coronary intervention after resuscitated cardiac arrest and during ongoing cardiocerebral resuscitation.
Recent Findings:
In almost 450 patients with acute ST-elevation myocardial infarction after reestablishment of spontaneous circulation, success rate of primary percutaneous coronary intervention was 89%. Survival rates in conscious patients after reestablishment of spontaneous circulation were comparable to patients without preceding cardiac arrest while in comatose patients, survival was 57% and survival with acceptable neurological outcome 38%. Nonrandomized trials in 106 comatose survivors of cardiac arrest indicate that urgent invasive coronary strategy can be safely combined with mild induced hypothermia. Percutaneous coronary intervention is also feasible in patients undergoing cardiocerebral resuscitation. In 34 reported patients, the success rate of percutaneous coronary intervention was 88% and survival to hospital discharge 41%.
Summary:
Urgent coronary angiography and percutaneous coronary intervention should be attempted in conscious patients after reestablishment of spontaneous circulation similarly as in patients with acute coronary syndromes without preceding cardiac arrest. In comatose survivors, urgent coronary strategy is reasonable if acute ischemic cause is suspected and if there is realistic hope for neurological recovery that should be facilitated with mild induced hypothermia. Urgent coronary invasive strategy may be successful also during ongoing resuscitation in selected patients without advanced heart diseases and significant comorbidities.
More Related Videos
Related Concept Videos
01:28Acute Coronary Syndrome IV: Interprofessional Care
01:30Acute Coronary Syndrome I: Introduction
01:25Cardiopulmonary Resuscitation IV: Pharmacological Management
01:26Acute Coronary Syndrome V: Nursing Management
01:30Introduction Cardiac Emergencies
01:30Acute Coronary Syndrome III: Diagnostic Studies