While neurologic outcomes after out-of-hospital cardiac arrest (OHCA) have been extensively studied, long-term cardiovascular outcomes remain underexplored. Coronary angiography (CAG) and revascularization status may reflect both the clinical status and the underlying arrest etiology, providing insight into subsequent cardiovascular risk. We conducted a retrospective nationwide cohort study using the Korean National Health Insurance Service database (2010-2019). Adult survivors of non-traumatic OHCA were classified by according to CAG/revascularization status during index hospitalization: no CAG (no-CAG), CAG without revascularization (CAG-only), and CAG with percutaneous coronary intervention or coronary artery bypass grafting (PCI/CABG). The primary outcome was 1-year major adverse cardiovascular events (MACE), defined as a composite of acute coronary syndrome or ischemic heart disease, stroke, and heart failure. Among 32,497 OHCA survivors (mean age ~ 63 years; 69% male), 1-year MACE incidence was highest in the no-CAG group (58.2%), followed by PCI/CABG (35.6%) and CAG-only (29.3%) (P < 0.001). Compared with the PCI/CABG group, the no-CAG group was associated with a higher risk of 1-year MACE (HR 1.65), whereas the CAG-only group showed no significant difference in MACE risk (HR 0.96; p = 0.166). The PCI/CABG group showed higher risks of ischemic events and heart failure, whereas stroke was more frequent in the CAG-only group. CAG/revascularization status was associated with 1-year cardiovascular outcomes and may help inform post-arrest cardiovascular risk stratification.
Kim et al. (Wed,) studied this question.