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{
    "pk": 9274,
    "title": "Troponin Marker for Acute Coronary Occlusion and Patient Outcome Following Cardiac Arrest",
    "subtitle": null,
    "abstract": "Introduction:\n The utility of troponin as a marker for acute coronary occlusion and patient outcome after out-of-hospital cardiac arrest (OHCA) is unclear. We sought to determine whether initial or peak troponin was associated with percutaneous coronary intervention (PCI), OHCA survival or neurological outcome. \nMethods:\n Single-center retrospective-cohort study of OHCA patients treated in a comprehensive clinical pathway from November 2007 to October 2012. Troponin I levels were acquired at presentation, four and eight hours after arrest, and then per physician discretion. Cardiac catheterization was at the cardiologist’s discretion. Survival and outcome were determined at hospital discharge, with cerebral performance category score 1-2 defined as a good neurological outcome. \nResults:\n We enrolled 277 patients; 58% had a shockable rhythm, 44% survived, 41% good neurological outcome. Of the 107 (38%) patients who underwent cardiac catheterization, 30 (28%) had PCI. Initial ED troponin (median, ng/mL) was not different in patients requiring PCI vs no PCI (0.32 vs 0.09, p=0.06), although peak troponin was higher (4.19 versus 1.57, p=0.02). Of the 85 patients who underwent cardiac catheterization without STEMI (n=85), there was no difference in those who received PCI vs no PCI in initial troponin (0.22 vs 0.06, p=0.40) or peak troponin (2.58 vs 1.43, p=0.27). Regarding outcomes, there was no difference in initial troponin in survivors versus non-survivors (0.09 vs 0.22, p=0.11), or those with a good versus poor neurological outcome (0.09 vs 0.20, p=0.11). Likewise, there was no difference in peak troponin in survivors versus non-survivors (1.64 vs 1.23, p=0.07), or in those with a good versus poor neurological outcome (1.57 vs 1.26, p=0.14).\nConclusion: \nIn our single-center patient cohort, peak troponin, but not initial troponin, was associated with higher likelihood of PCI, while neither initial nor peak troponin were associated with survival or neurological outcome in OHCA patients.",
    "language": "en",
    "license": {
        "name": "Creative Commons Attribution 4.0",
        "short_name": "CC BY 4.0",
        "text": "Attribution — You must give appropriate credit, provide a link to the license, and indicate if changes were made. You may do so in any reasonable manner, but not in any way that suggests the licensor endorses you or your use.\r\n\r\nNo additional restrictions — You may not apply legal terms or technological measures that legally restrict others from doing anything the license permits.",
        "url": "https://creativecommons.org/licenses/by/4.0"
    },
    "keywords": [
        {
            "word": "Cardiac arrest, percutaneous coronary intervention"
        }
    ],
    "section": "Health Outcomes",
    "is_remote": true,
    "remote_url": "https://escholarship.org/uc/item/76v5q4sc",
    "frozenauthors": [
        {
            "first_name": "David",
            "middle_name": "Andres",
            "last_name": "Pearson",
            "name_suffix": "",
            "institution": "Carolinas Medical Center",
            "department": "None"
        },
        {
            "first_name": "Catherine",
            "middle_name": "M.",
            "last_name": "Wares",
            "name_suffix": "",
            "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Katherine",
            "middle_name": "A.",
            "last_name": "Mayer",
            "name_suffix": "",
            "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Michael",
            "middle_name": "S.",
            "last_name": "Runyon",
            "name_suffix": "",
            "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Jonathan",
            "middle_name": "R.",
            "last_name": "Studnek",
            "name_suffix": "",
            "institution": "Mecklenburg EMS Agency, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Shana",
            "middle_name": "L.",
            "last_name": "Ward",
            "name_suffix": "",
            "institution": "Carolinas Health Care System, Dickson Advanced Analytics Group, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Kathi",
            "middle_name": "M.",
            "last_name": "Kraft",
            "name_suffix": "",
            "institution": "Carolinas Health Care System, Dickson Advanced Analytics Group, Charlotte, North Carolina",
            "department": "None"
        },
        {
            "first_name": "Alan",
            "middle_name": "C.",
            "last_name": "Heffner",
            "name_suffix": "",
            "institution": "Carolinas Medical Center, Department of Emergency Medicine, Charlotte, North Carolina; Carolinas Medical Center, Department of Internal Medicine, Division of Critical Care Medicine, Charlotte, North Carolina",
            "department": "None"
        }
    ],
    "date_submitted": "2015-08-04T16:23:09Z",
    "date_accepted": "2015-08-04T16:23:09Z",
    "date_published": "2015-12-08T21:40:52Z",
    "render_galley": null,
    "galleys": [
        {
            "label": "",
            "type": "pdf",
            "path": "https://journalpub.escholarship.org/westjem/article/9274/galley/5238/download/"
        }
    ]
}