Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI/Stent for Life (SFL) groups

NOC, Marko, Jean FAJADET, Jens F. LASSEN, Petr KALA, Philip MACCARTHY, Goran K. OLIVECRONA, Stephan WINDECKER and Christian SPAULDING. Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI/Stent for Life (SFL) groups. Eurointervention. Toulouse: Europa edition, 2014, vol. 10, No 1, p. 31-37. ISSN 1774-024X. Available from: https://dx.doi.org/10.4244/EIJV10I1A7.

Basic information

• Original name: Invasive coronary treatment strategies for out-of-hospital cardiac arrest: a consensus statement from the European Association for Percutaneous Cardiovascular Interventions (EAPCI/Stent for Life (SFL) groups
• Authors: NOC, Marko (705 Slovenia), Jean FAJADET (250 France), Jens F. LASSEN (208 Denmark), Petr KALA (203 Czech Republic, guarantor, belonging to the institution), Philip MACCARTHY (826 United Kingdom of Great Britain and Northern Ireland), Goran K. OLIVECRONA (752 Sweden), Stephan WINDECKER (756 Switzerland) and Christian SPAULDING (250 France).
• Edition: Eurointervention, Toulouse, Europa edition, 2014, 1774-024X.

Other information

• Original language: English
• Type of outcome: Article in a journal
• Field of Study: 30201 Cardiac and Cardiovascular systems
• Country of publisher: France
• Confidentiality degree: is not subject to a state or trade secret
• Impact factor: Impact factor: 3.769
• RIV identification code: RIV/00216224:14110/14:00078394
• Organization unit: Faculty of Medicine
• Doi: http://dx.doi.org/10.4244/EIJV10I1A7
• UT WoS: 000338980900009
• Keywords in English: cardiac arrest; coronary angiography; PCI
• Tags: EL OK
• Tags: International impact, Reviewed

Abstract

Due to significant improvement in the pre-hospital treatment of patients with out-of-hospital cardiac arrest (OHCA), an increasing number of initially resuscitated patients are being admitted to hospitals. Because of the limited data available and lack of clear guideline recommendations, experts from the EAPCI and "Stent for Life" (SFL) groups reviewed existing literature and provided practical guidelines on selection of patients for immediate coronary angiography (CAG), PCI strategy, concomitant antiplatelet/anticoagulation treatment, haemodynamic support and use of therapeutic hypothermia. Conscious survivors of OHCA with suspected acute coronary syndrome (ACS) should be treated according to recommendations for ST-segment elevation myocardial infarction (STEMI) and high-risk non-ST-segment elevation -ACS (NSTE-ACS) without OHCA and should undergo immediate (if STEMI) or rapid (less than two hours if NSTE-ACS) coronary invasive strategy. Comatose survivors of OHCA with ECG criteria for STEMI on the post-resuscitation ECG should be admitted directly to the catheterisation laboratory. For patients without STEMI ECG criteria, a short "emergency department or intensive care unit stop" is advised to exclude non-coronary causes. In the absence of an obvious non-coronary cause, CAG should be performed as soon as possible (less than two hours), in particular in haemodynamically unstable patients. Immediate PCI should be mainly directed towards the culprit lesion if identified. Interventional cardiologists should become an essential part of the "survival chain" for patients with OHCA. There is a need to centralise the care of patients with OHCA to experienced centres.