This retrospective single-centre study examined first post-ROSC ECGs in 214 cardiac arrest survivors admitted to a tertiary ICU; 101 had angiographically confirmed occlusive myocardial infarction. Non-ST-elevation occlusion patterns were more prevalent than STEMI patterns overall (35% versus 24%), but angiography was less frequent (78% versus 98%; p=0.002). Patients with non-ST-elevation occlusion patterns who did not undergo angiography had the highest 30-day mortality (75%; p=0.005). After multivariable adjustment, PR-segment prolongation was associated with lower 30-day survival (adjusted odds ratio 0.977, reported interval 0.956–0.998; p=0.032).
Post-ROSC ECG morphology and PR-segment duration may offer diagnostic and prognostic information. These observational findings do not establish that angiography improves survival in patients with non-ST-elevation occlusion patterns.
Study limitation: Retrospective single-centre data and nonrandom angiography selection limit causal interpretation of mortality differences.
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