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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

Authors
Park, JiesuckShin, JonghwanKim, Hack-LyoungSong, Kyoung JunJung, Jin HeeLee, Hui JaiYou, Kyoung MinLim, Woo-HyunSeo, Jae-BinKim, Sang-HyunZo, Joo-HeeKim, Myung-AKim, Do KyunHan, Sang KukChoi, Phil ChoPark, Sang O.Kim, Jong WonChoi, Han SungLee, Jong SeokChoi, Sung HyukYoon, Young HoonKim, Soo JinSim, Min SeobLee, Gun TakAhn, ShinPark, Sang HyunPark, Keun HongPark, In CheolPark, Yoo SeokKong, Tae YoungLee, Kyoung WonKim, Chu HyunCho, YoungsukKang, Gu HyunJang, Yong SooIm, Tai HoOh, Jae HoonYeom, Seok RanHan, Sang KyoonLee, Jae HoonPark, Jeong BaeRyoo, Hyun WookLee, Kyung WooJang, Tae ChangWoo, Jae-hyugLee, Woon JeongWoo, Seon HeeYun, Sung HyunCho, Tae JinKim, Sun PyoPark, Yong JinLee, Jin WoongJeong, WonjoonPark, Sung SooLee, Jae KwangAhn, RyeokChoi, Wook JinMin, Young GiPark, Eun JungJo, You HwanKim, Joong HeeKim, In ByungAhn, Ki OkCho, Han JinLee, Seung CheolLee, Sang HunKim, Young SikHa, Young RockPark, Jin SikLee, Myoung WooWi, Dai HanKim, Ok JunChung, Tae NyoungWang, Soon JooPark, Hang A.Cho, Jun HwiPark, Chan WooEob, An MuLee, Tae HunKim, Sang ChulKim, HoonChoi, Han JooKoh, Chan YoungLee, Jung WonLee, Dong WookJung, Tae OhYoon, Jae CholChoi, Dai HaiChoi, Jung TaeJeong, Jin HeeLee, Soo HoonRyu, Ji HoPark, Maeng RealKim, WonSong, Sung WookKim, Woo JungKwon, Joon-myoungKang, Eui HyukJin, Sang ChanKim, Tae-kwonChoi, Hyuk JoongKim, Seong ChunHwang, Sung OhShin, Sang DoYang, Hyuk JunChung, Sung PhilLee, Sung WooHwang, Seung SikCho, Gyu ChongMoon, Sung WooCha, Kyoung ChulKim, Won YoungNa, Sang HoonKwack, Young HoKim, Joo YeongPark, Jeong HoLee, Sun YoungKim, Jung Eun
Issue Date
10-6월-2019
Publisher
KOREAN ACAD MEDICAL SCIENCES
Keywords
Coronary Angiography; Coronary Artery Disease; Out-of-Hospital Cardiac Arrest; Risk Factors
Citation
JOURNAL OF KOREAN MEDICAL SCIENCE, v.34, no.22
Indexed
SCIE
SCOPUS
KCI
Journal Title
JOURNAL OF KOREAN MEDICAL SCIENCE
Volume
34
Number
22
URI
https://scholar.korea.ac.kr/handle/2021.sw.korea/64783
DOI
10.3346/jkms.2019.34.e159
ISSN
1011-8934
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.
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