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. doi: 10.1016/j.resuscitation.2016.12.004. Epub 2016 Dec 14.

Abstract

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.

Keywords: Angiography; Cardiopulmonary resuscitation; Fibrinolysis; Heart arrest; Thrombolysis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aged
  • Cardiac Catheterization
  • Cardiopulmonary Resuscitation
  • Electrocardiography*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Out-of-Hospital Cardiac Arrest / blood
  • Out-of-Hospital Cardiac Arrest / mortality
  • Out-of-Hospital Cardiac Arrest / physiopathology*
  • Out-of-Hospital Cardiac Arrest / therapy*
  • Reperfusion
  • Troponin / blood*

Substances

  • Troponin