The association of maximum Troponin values post out-of-hospital cardiac arrest with electrocardiographic findings, cardiac reperfusion procedures and survival to discharge: A sub-study of ROC PRIMED. Resuscitation 2017 Feb;111:82-89
Date
12/19/2016Pubmed ID
27988273DOI
10.1016/j.resuscitation.2016.12.004Scopus ID
2-s2.0-85018509649 (requires institutional sign-in at Scopus site) 3 CitationsAbstract
BACKGROUND: The role of Troponin (Tn) levels in the management of patients post out-of-hospital cardiac arrest (OHCA) is unclear.
METHODS: All OHCA patients enrolled in the Resuscitation Outcomes Consortium Prehospital Resuscitation using an IMpedance valve and Early versus Delayed analysis trial and admitted to hospital with a Tn level and a 12-lead electrocardiogram were stratified by ST elevation (STE) or no STE in a regression model for survival to discharge adjusted for Utstein predictors and site.
RESULTS: Of the 15,617 enrolled OHCA patients, 4118 (26%) survived to admission to hospital; 17% (693) were STE and 77% (3188) were no STE with 6% unknown; 83% (3460) had at least one Tn level. Reperfusion rates were higher when Tn level >2ng/ml (p>0.1ng/ml) improved with a diagnostic cardiac catheterization (p<0.001).
CONCLUSIONS: Elevated Tn levels >2ng/ml were associated with improved survival to discharge in patients post OHCA with STE. Survival in patients with no STE and Tn values >0.1ng/ml was higher when associated with diagnostic cardiac catheterization or treated with reperfusion or revascularization.
Author List
Morrison LJ, Devlin SM, Kontos MC, Cheskes S, Aufderheide TP, Christenson J, Ornato JP, Stiell IG, Rac VE, Thomas AJ, Wigginton JG, Dorian P, Resuscitation Outcomes Consortium InvestigatorsAuthor
Tom P. Aufderheide MD Professor in the Emergency Medicine department at Medical College of WisconsinMESH terms used to index this publication - Major topics in bold
AgedCardiac Catheterization
Cardiopulmonary Resuscitation
Electrocardiography
Female
Humans
Male
Middle Aged
Out-of-Hospital Cardiac Arrest
Reperfusion
Troponin