Characteristics and Outcomes in Patients Undergoing Percutaneous Coronary Intervention Following Cardiac Arrest (from the NCDR) Navdeep Gupta, MBBSa,*, Michael C. Kontos, MDb, Aditi Gupta, MBBSc, David Dai, PhDd, George W. Vetrovec, MDb, Matthew T. Roe, MDd, and John Messenger, MDe Outcomes in patients with out-of-hospital cardiac arrest (CA) who undergo percutaneous coronary intervention (PCI) have been limited to small, mostly single-center studies. We compared patients who underwent PCI after CA included in the CathPCI Registry with those without CA. Patients with ST elevation were classified as ST-elevation myocardial infarction (STEMI); all other patients having PCI were classified as without STEMI. Patients with CA in each group were compared with the corresponding non-CA groups for baseline characteristics, angiographic findings, and outcomes. A total of 594,734 patients underwent PCI, of whom 114,768 had STEMI, including 9,375 (8.2%) had CA, and 479,966 had without STEMI, including 2,775 (0.6%) had CA. Patients with CA were similar in age to patients with non-CA, with a lower frequency of coronary disease risk factors and known coronary disease. On angiography, patients with CA were significantly more likely to have more complex lesions with worse baseline thrombolysis in myocardial infarction flow. Patients with CA were significantly more likely to have cardiogenic shock, both for patients with STEMI (51% vs 7.2%, respectively) and for patients without STEMI (38% vs 0.8%, respectively, both p 1,300 participating sites sponsored by the American College of Cardiology and the Society for Cardiovascular Angiography and Interventions.8,9 Data are captured at participating hospitals and include patient and hospital characteristics, procedural findings, interventions, and outcomes.8,9 The NCDR also has a comprehensive data quality program, including data abstraction training, data quality thresholds for inclusion, site data quality feedback reports, independent auditing, and data validation.9,10 Data auditing has demonstrated accurate representation with agreement with chart review >93%.10 Data elements and definitions are available at https://www. ncdr.com/WebNCDR/docs/public-data-collection-documents/ cathpci_v4_codersdictionary_4-4.pdf?sfvrsn¼2. All data www.ajconline.org

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Figure 1. Patient distribution based on the presence or absence of ST elevation or CA. CA ¼ cardiac arrest; PCI ¼ percutaneous coronary intervention.

were collected using version 3 of the data collection form. This research was supported by the American College of Cardiology Foundation’s NCDR. Patients who underwent PCI from August 2009 through July 2010 were included. Patients were classified into 4 groups based on whether they had CA before PCI and whether they met criteria for STEMI (Figure 1). Patients who underwent coronary angiography without PCI (n ¼ 4,244) or those without information on CA (n ¼ 352) were excluded. Patients not classified as having STEMI were classified as without STEMI (non-STEMI, 1,624 [59%]; unstable angina, 598 [22%]; stable angina, 161 [5.8%]; atypical chest pain, 58 [2.1%]; and asymptomatic, 334 [12%]). CA was defined as a pulseless clinical scenario that could be bradycardic or tachycardic, requiring cardiopulmonary resuscitation (requiring 2 or more chest compressions or open chest massage) and/or requiring emergency defibrillation within 24 hours before PCI. We also analyzed the subgroup of patients who had cardiogenic shock at presentation or after PCI. Cardiogenic shock was defined as sustained (>30 minutes) systolic blood pressure