This retrospective single-centre study examined 149 resuscitated out-of-hospital cardiac arrest patients who underwent coronary angiography and had presumed culprit lesions. Post-resuscitation ST-segment elevation was associated with a more acute occlusive phenotype, impaired culprit-vessel flow and greater myocardial injury. Patients without ST-segment elevation more often had multivessel disease and chronic total occlusion, indicating differing coronary anatomy within this selected population. Favorable neurological outcomes were less frequent with ST-segment elevation in unadjusted analyses, but the association was not independent of pre-hospital factors; adjusted effect estimates and outcome timing were not reported.
Post-resuscitation ST-segment findings distinguished coronary phenotypes in this selected cohort, but ST-segment elevation was not independently associated with clinical outcomes after adjustment for pre-hospital factors.
Study limitation: Retrospective, single-centre selection restricted to angiography-evaluable patients with presumed culprit lesions substantially limits generalizability.
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