Abstract 16386: Predicting Cardiac Arrest Myocardial Infarction (PreCAMI) in Out of Hospital Cardiac Arrest (OHCA) Survivors Lacking ST Elevations (STE)

Introduction: Coronary angiography (CA) and percutaneous intervention (PCI) after OHCA is recommended for suspected coronary occlusion based on ST elevation (STE) by ECG, yet 20-40% of OHCA patients without STE also have occlusions. Hypothesis: Clinical criteria available prior to CA can be used to create a score to predict whether PCI will be attempted in non-STE OHCA patients with sensitivity (Sn) and specificity (Sp) nearing STE. Attempted PCI in non-STE OHCA will be associated with improved survival and functional outcomes. Methods: We abstracted historical, demographic, resuscitation, ECG and lab data available within 6h of hospitalization in 156 non-STE OHCA who underwent early CA ( Results: 61/156 (39.1%) OHCA subjects without STE had attempted PCI. We derived a 4 variable (initial troponin, male sex, VF/VT presentation, epinephrine doses during CPR) parsimonious model (AUROC 0.78) which predicted PCI attempt with Sn 83%/Sp 51% comparing favorably to STE at our center (Sn 62%/Sp 77%). In Cochin 111/467 (24%) of CA resulted in PCI. Score validation in 407 OHCA with complete data yielded Sn 68%/Sp 50% for predicting PCI use in CA. Attempted PCI, but not CA alone, was associated with improved outcomes (US cohort). ( Table ). Conclusion: We9ve validated a 4 variable score which predicts PCI use in OHCA without STE. PCI use in this population is associated with improved outcomes.