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World J Cardiol. Jun 26, 2014; 6(6): 444-448
Published online Jun 26, 2014. doi: 10.4330/wjc.v6.i6.444
Invasive strategy in patients with resuscitated cardiac arrest and ST elevation myocardial infarction
Vojka Gorjup, Marko Noc, Peter Radsel
Vojka Gorjup, Marko Noc, Peter Radsel, Department of Intensive Internal Medicine, University Medical Center Ljubljana, 1000 Ljubljana, Slovenia
Author contributions: Noc M designed figure; Radsel Pdesigned table; all the authors wrote the article.
Correspondence to: Peter Radsel, MD, PhD, Department of Intensive Internal Medicine, University Medical Center Ljubljana, Zaloska 7, 1000 Ljubljana, Slovenia. peter.radsel@mf.uni-lj.si
Telephone: +38-61-5223182 Fax: +38-61-5222236
Received: December 28, 2013
Revised: February 7, 2014
Accepted: April 16, 2014
Published online: June 26, 2014
Processing time: 180 Days and 12.7 Hours
Abstract

Coronary artery disease is the most frequent cause of sudden cardiac death. There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in post-resuscitation electrocardiogram. In these patients acute coronary thrombotic lesion (“ACS” lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and safe but highly effective and there is evidence of improved survival with good neurological outcome. PCI of the culprit lesion is the primary goal while PCI of stable obstructive lesions may be postponed unless post-resuscitation cardiogenic shock is present.

Keywords: Sudden cardiac arrest; ST-elevation myocardial infarction; Coronary angiography; Percutaneous coronary intervention

Core tip: There is general consensus that immediate coronary angiography with percutaneous coronary intervention (PCI) should be performed in all conscious and unconscious patients with ST-elevation myocardial infarction in postresuscitation electrocardiogram. In these patients, acute coronary thrombotic lesion (“ACS” lesion) suitable for PCI is typically present in more than 90%. PCI in these patients is not only feasible and safe but highly effective and there is evidence of improved survival with good neurological outcome. PCI of the culprit lesion is the primary goal while PCI of stable obstructive lesions may be postponed unless postresuscitation cardiogenic shock is present.