Sarak, B, Goodman, SG, Brieger, D et al. (10 more authors) (2018) Electrocardiographic Findings in Patients with Acute Coronary Syndrome Presenting with Out-of-Hospital Cardiac Arrest. American Journal of Cardiology, 121 (3). pp. 294-300. ISSN 0002-9149
Abstract
We sought to characterize presenting electrocardiographic findings in patients with acute coronary syndromes (ACS) and out-of-hospital cardiac arrest (OHCA). In the Global Registry of Acute Coronary Events (GRACE) and Canadian ACS Registry I, we examined presenting and 24-48 hour follow-up ECGs of ACS patients who survived to hospital admission, stratified by presentation with OHCA. We assessed the prevalence of ST-segment deviation and bundle branch blocks and their association with in-hospital and 6-month mortality amongst those with OHCA. 215 (1.8%) of 12,040 ACS patients survived to hospital admission following OHCA. Those with OHCA had higher presenting rates of ST-segment elevation, ST-segment depression, T wave inversion, precordial Q waves, left bundle branch block (LBBB), and right bundle branch block (RBBB) than those without. Among patients with OHCA, those with ST-segment elevation had significantly lower in-hospital mortality (20.9% vs. 33.0%, p=0.044) and a trend toward lower 6-month mortality (27% vs. 39%, p=0.060) compared to those without ST-segment elevation. Conversely, among OCHA patients, LBBB was associated with significantly higher in-hospital and 6-month mortality rates (58% vs. 22%, p<0.001 and 65% vs. 28%, p<0.001 respectively). ST-segment depression and RBBB were not associated with either outcome. 63% of bundle branch blocks (RBBB or LBBB) on the presenting ECG resolved by 24-48 hours. In conclusion, compared with ACS patients without cardiac arrest, those with OHCA had higher rates of ST-segment elevation, LBBB and RBBB on admission. Among OHCA patients, ST-segment elevation was associated with lower in-hospital mortality, while LBBB was associated with higher in-hospital and 6-month mortality.
Metadata
Item Type: | Article |
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Authors/Creators: |
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Copyright, Publisher and Additional Information: | © 2017 Elsevier Inc. This is an author produced version of a paper published in The American Journal of Cardiology. Uploaded in accordance with the publisher's self-archiving policy. |
Keywords: | Acute coronary syndrome; out-of-hospital cardiac arrest; electrocardiogram |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Cardiovascular and Metabolic Medicine (LICAMM) |
Depositing User: | Symplectic Publications |
Date Deposited: | 08 Nov 2017 11:19 |
Last Modified: | 03 Nov 2018 01:38 |
Status: | Published |
Publisher: | Elsevier |
Identification Number: | 10.1016/j.amjcard.2017.10.030 |
Related URLs: | |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:123653 |