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Clinical Factors Associated with Obstructive Coronary Artery Disease in Patients with Out-of-Hospital Cardiac Arrest: Data from the Korean Cardiac Arrest Research Consortium (KoCARC) Registry

Cited 5 time in Web of Science Cited 5 time in Scopus
Authors

Park, Jiesuck; Shin, Jonghwan; Kim, Hack-Lyoung; Song, Kyoung Jun; Jung, Jin Hee; Lee, Hui Jai; You, Kyoung Min; Lim, Woo-Hyun; Seo, Jae-Bin; Kim, Sang-Hyun; Zo, Joo-Hee; Kim, Myung-A; Kim, Do Kyun; Han, Sang Kuk; Choi, Phil Cho; Park, Sang O.; Kim, Jong Won; Choi, Han Sung; Lee, Jong Seok; Choi, Sung Hyuk; Yoon, Young Hoon; Kim, Soo Jin; Sim, Min Seob; Lee, Gun Tak; Ahn, Shin; Park, Sang Hyun; Park, Keun Hong; Park, In Cheol; Park, Yoo Seok; Kong, Tae Young; Lee, Kyoung Won; Kim, Chu Hyun; Cho, Youngsuk; Kang, Gu Hyun; Jang, Yong Soo; Im, Tai Ho; Oh, Jae Hoon; Yeom, Seok Ran; Han, Sang Kyoon; Lee, Jae Hoon; Park, Jeong Bae; Ryoo, Hyun Wook; Lee, Kyung Woo; Jang, Tae Chang; Woo, Jae-hyug; Lee, Woon Jeong; Woo, Seon Hee; Yun, Sung Hyun; Cho, Tae Jin; Kim, Sun Pyo; Park, Yong Jin; Lee, Jin Woong; Jeong, Wonjoon; Park, Sung Soo; Lee, Jae Kwang; Ahn, Ryeok; Choi, Wook Jin; Min, Young Gi; Park, Eun Jung; Jo, You Hwan; Kim, Joong Hee; Kim, In Byung; Ahn, Ki Ok; Cho, Han Jin; Lee, Seung Cheol; Lee, Sang Hun; Kim, Young Sik; Ha, Young Rock; Park, Jin Sik; Lee, Myoung Woo; Wi, Dai Han; Kim, Ok Jun; Chung, Tae Nyoung; Wang, Soon Joo; Park, Hang A.; Cho, Jun Hwi; Park, Chan Woo; Eob, An Mu; Lee, Tae Hun; Kim, Sang Chul; Kim, Hoon; Choi, Han Joo; Koh, Chan Young; Lee, Jung Won; Lee, Dong Wook; Jung, Tae Oh; Yoon, Jae Chol; Choi, Dai Hai; Choi, Jung Tae; Jeong, Jin Hee; Lee, Soo Hoon; Ryu, Ji Ho; Park, Maeng Real; Kim, Won; Song, Sung Wook; Kim, Woo Jung; Kwon, Joon-myoung; Kang, Eui Hyuk; Jin, Sang Chan; Kim, Tae-kwon; Choi, Hyuk Joong; Kim, Seong Chun; Hwang, Sung Oh; Shin, Sang Do; Yang, Hyuk Jun; Chung, Sung Phil; Lee, Sung Woo; Hwang, Seung Sik; Cho, Gyu Chong; Moon, Sung Woo; Cha, Kyoung Chul; Kim, Won Young; Na, Sang Hoon; Kwack, Young Ho; Kim, Joo Yeong; Park, Jeong Ho; Lee, Sun Young; Kim, Jung Eun

Issue Date
2019-06
Publisher
대한의학회
Citation
Journal of Korean Medical Science, Vol.34 No.22, p. e159
Abstract
Background: Although coronary artery disease (CAD) is a major cause of out-of-hospital cardiac arrest (OHCA), there has been no convinced data on the necessity of routine invasive coronary angiography (ICA) in OHCA. We investigated clinical factors associated with obstructive CAD in OHCA. Methods: Data from 516 OHCA patients (mean age 58 years, 83% men) who underwent ICA after resuscitation was obtained from a nation-wide OHCA registry. Obstructive CAD was defined as the lesions with diameter stenosis >= 50% on ICA. Independent clinical predictors for obstructive CAD were evaluated using multiple logistic regression analysis, and their prediction performance was compared using area under the receiver operating characteristic curve with 10,000 repeated random permutations. Results: Among study patients, 254 (49%) had obstructive CAD. Those with obstructive CAD were older (61 vs. 55 years, P < 0.001) and had higher prevalence of hypertension (54% vs. 36%, P < 0.001), diabetes mellitus (29% vs. 21%, P = 0.032), positive cardiac enzyme (84% vs. 74%, P = 0.010) and initial shockable rhythm (70% vs. 61%, P = 0.033). In multiple logistic regression analysis, old age (>= 60 years) (odds ratio [On 2.01; 95% confidence interval [CI], 1.36-3.00; P = 0.001), hypertension (OR, 1.74; 95% CI, 1.18-2.57; P = 0.005), positive cardiac enzyme (OR, 1.72; 95% CI, 1.09-2.70; P = 0.019), and initial shockable rhythm (OR, 1.71; 95% CI, 1.16-2.54; P = 0.007) were associated with obstructive CAD. Prediction ability for obstructive CAD increased proportionally when these 4 factors were sequentially combined (P < 0.001). Conclusion: In patients with OHCA, those with old age, hypertension, positive cardiac enzyme and initial shockable rhythm were associated with obstructive CAD. Early ICA should be considered in these patients.
ISSN
1011-8934
URI
https://hdl.handle.net/10371/190340
DOI
https://doi.org/10.3346/jkms.2019.34.e159
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