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Cardiac arrest
Post-ROSC ST elevation tracks acute coronary occlusion
Post-resuscitation ST-segment elevation and coronary angiographic phenotypes in angiography-evaluable survivors of out-of-hospital cardiac arrest with presumed coronary lesion-related arrest
Resuscitation · 2026-11 · Added 4 November 2026
A Japanese single-centre review of 149 angiography-evaluable OHCA survivors with presumed culprit lesions found post-resuscitation ST-segment elevation marked an acute occlusive coronary phenotype but was not independently linked to neurological outcome once prehospital factors were accounted for.
- Study type
- Cohort
- Design
- Retrospective single-centre cohort
- Participants
- 149 successfully resuscitated OHCA patients undergoing post-resuscitation angiography
- Main finding
- ST elevation was associated with more impaired culprit-vessel flow and greater myocardial injury; patients without ST elevation more often had multivessel disease or chronic total occlusion; ST elevation was not independently associated with neurological outcome after adjustment for prehospital factors
- Caveat
- Heavy selection: single centre, angiography-evaluable survivors with presumed culprit lesions only
- Bottom line
- Hypothesis-generating
Why it matters in Australia (Medium relevance). The cath-lab call after ROSC sits mostly with receiving hospitals here, but the practical message for crews — absence of ST elevation doesn't rule out a coronary culprit — belongs in the handover.
Learning goal
Refine my interpretation of post-ROSC ECG patterns when deciding coronary cause and destination in cardiac arrest.
More
- Topic: Cardiac arrest
- Daily scan: 4 November 2026
- Podcast: Paramedic Papers Daily, 4 November 2026
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