Evelin Szabó, Diana Opincariu, Zsolt Parajkó, Noémi Mitra, Theodora Benedek and Imre Benedek
Out-of-hospital cardiac arrest (OHCA) has a poor prognosis and is the most severe complication of any cardiac event. It is known from previous studies that the location of the culprit lesion in ST-segment elevation myocardial infarction (STEMI) patients with cardiac arrest may affect the post resuscitation survival rate. However, due to the low number of cases, the association between the localization of the culprit lesion within the coronary tree and the occurrence of cardiac arrest is not widely discussed, because resuscitated cardiac arrest patients are excluded from the vast majority of clinical trials. This is a prospective observational study that aims to develop a prediction model for OHCA in patients who present with STEMI, based on differences related to culprit lesion location. The primary objective of the study is to evaluate the differences related to the location of the culprit lesion in patients with STEMI who present OHCA versus patients without cardiac arrest.
Noémi Mitra, Roxana Hodas, Evelin Szabó, Zsolt Parajkó, Theodora Benedek and Imre Benedek
With coronary artery disease (CAD) projected to remain the leading cause of global mortality, prevention strategies seem to be the only effective approach able to reduce the burden and improve mortality and morbidity. At this moment, diagnostic strategies focus mainly on symptomatic patients, ignoring the occurrence of major cardiovascular events as the only manifestation of CAD. As two thirds of fatal myocardial infarction are resulting from plaque rupture, an approach based on the “vulnerable plaque” concept is mandatory in order to improve patient diagnosis, treatment, and, by default, prognosis. Given that the main studies focus on a plaque-centered approach, this is a prospective observational study that will perform a complex assessment of the features that characterize unstable coronary lesions, in terms of both local assessment via specific coronary computed tomography angiography markers of coronary plaque vulnerability and systemic approach based on serological markers of systemic inflammation in patients proved to be “vulnerable” by developing acute cardiovascular events.