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Clinical Implication of Coronary Artery Calcium Score in Survivors of Out-of-Hospital Cardiac Arrest

Koichiro Matsumura1, Hiromi Kin1, Kenichi Fujii2

  • 1Department of Cardiology, Kansai Medical University Medical Center Osaka Japan.

Circulation Reports
|March 11, 2021
PubMed

Insights

Coronary artery calcium (CAC) scoring effectively identifies acute myocardial infarction (AMI) in out-of-hospital cardiac arrest (OHCA) survivors. This method aids diagnosis regardless of electrocardiogram (ECG) findings post-resuscitation.

Area of Science:

  • Cardiology
  • Radiology
  • Emergency Medicine

Background:

  • Out-of-hospital cardiac arrest (OHCA) survivors require rapid diagnosis of acute myocardial infarction (AMI).
  • Electrocardiogram (ECG) findings post-resuscitation can be ambiguous, complicating AMI diagnosis.
  • Coronary artery calcium (CAC) scoring is a non-invasive imaging technique.

Purpose of the Study:

  • To assess the diagnostic accuracy of CAC scoring for identifying AMI in OHCA survivors.
  • To determine if CAC scoring is useful irrespective of ST-segment changes on post-resuscitation ECG.
  • To evaluate CAC score as a predictor of short-term survival.

Main Methods:

  • Retrospective analysis of 180 OHCA survivors undergoing non-contrast computed tomography (CT) and coronary angiography.
  • Patients were stratified into two groups based on post-resuscitation ECG: ST elevation/LBBB (group 1) and no ST elevation/LBBB (group 2).
  • CAC scores were compared between patients with and without AMI, and multivariate analysis was performed.

Main Results:

  • CAC score was significantly higher in patients with AMI in both ECG groups.
  • Optimal CAC score cut-offs for AMI detection were identified (11.5 for group 1, 27.4 for group 2).
  • CAC score emerged as the strongest independent predictor of AMI and a significant predictor of 30-day survival.

Conclusions:

  • CAC scoring is a valuable tool for diagnosing AMI in OHCA survivors.
  • The utility of CAC scoring is independent of ST-segment changes on post-resuscitation ECG.
  • CAC scoring aids in risk stratification and predicting survival in this patient population.

Keywords:
Acute myocardial infarctionOut-of-hospital cardiac arrestResuscitation

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