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Coronary Angiography May Improve Outcomes for Cardiac Arrest Patients

By MedImaging International staff writers
Posted on 21 Apr 2009

People who suffer cardiac arrests and then receive coronary angiography are twice as likely to survive without significant brain damage compared with those who do not have the procedure, according to a recent report.

The study, published in the May/June 2009 issue of the Journal of Intensive Care Medicine, and available online in April 2009, revealed that patient outcomes improved with coronary angiography, an imaging procedure that shows how blood flows through the heart, regardless of certain clinical and demographic factors that influenced who received the procedure.

"Given the low odds of survival--about 6%--for patients who suffer out-of-hospital cardiac arrests, it's important to understand which treatments might make a difference in these dismal outcomes," noted Jon C. Rittenberger, M.D., corresponding author of the study and an assistant professor in the department of emergency medicine at the University of Pittsburgh School of Medicine (UPMC; PA, USA). The importance of prompt coronary angiography is well established for cardiac arrest patients presenting with specific types of heart problems, Dr. Rittenberger noted. "But our study, which shows that angiography is independently associated with good neurologic outcomes, suggests that clinicians should consider the procedure for all postcardiac arrest patients," he added.

Coronary angiography uses a contrast dye and X-rays to see the blood vessels and chambers of the heart. The procedure is usually performed in conjunction with catheterization, which involves threading a thin hollow tube through an artery and into the heart. Dye is injected into the catheter and highlights any blockages in blood flow, which are then visible by X-ray.

The researchers retrospectively analyzed the charts of 241 adult cardiac arrest patients who were treated at UPMC Presbyterian Hospital, part of the University of Pittsburgh Medical Center, between January 1, 2005, and December 31, 2007. Coronary artery disease was present in 52% of the patients, and the rate did not differ between those who received coronary angiography (40% of the group) and those who did not. Those findings are consistent with earlier research showing that 60-80% of cardiac arrests are a result of cardiovascular disease.

Just over half of patients who received coronary angiography experienced a good clinical outcome--defined as being discharged to home or to an acute rehabilitation facility--compared to 24.8% of patients who do not have the procedure. Early angiography, performed within 24 hours of a patient's arrival, was not associated with improved survival when compared to having the procedure done later, but the researchers noted that the small number of patients might have made it impossible to validate a difference.

"Coronary angiography appears to put patients on a more proactive path of care, which may lead to a better outcome," said Dr. Rittenberger. "As this study demonstrates, most of these cardiac arrest patients have heart disease, which is often something that we can fix. Many of the patients who get coronary angiography go on to get bypass surgery, a balloon pump, a defibrillator, or other such aggressive treatments."

Dr. Rittenberger and his colleagues found no significant differences between those who received angiography and those who did not with respect to age, history of cardiac disease, and use of therapeutic hypothermia, a procedure used to cool patients who remain comatose after resuscitation following cardiac arrest to prevent brain damage.

However, patient sex, location of the arrest, the initial heart rhythm disturbance, and certain coronary and neurologic abnormalities were among the predictors of who would receive angiography. Men who suffered cardiac arrests outside of the hospital were more likely to have the procedure. The researchers also discovered that coronary angiography was more likely to be performed on patients with better neurologic status. Nevertheless, with the use of therapeutic hypothermia, patients may not reveal their true neurologic state for several days after the return of spontaneous blood circulation, they noted.

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61 (77.962875366211): select cover from jos_number where journalid in (5) and cover is not null order by left(issue,2)+right(issue,2)*12 desc limit 1

62 (530.00450134277): SELECT fid FROM jos_deeppockets WHERE id=294722886 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722886 AND published='1' LIMIT 1

63 (45.061111450195): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

64 (46.014785766602): select jos_twitters.link from jos_twitters where cat=10

65 (30.040740966797): select jos_facebook.link from jos_facebook where cat=10

66 (29.802322387695): select jos_google_plus.link from jos_google_plus where cat=10

67 (30.040740966797): select jos_linkedin.link from jos_linkedin where cat=10

68 (36.954879760742): SELECT fid FROM jos_deeppockets WHERE id=294722886 AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE id=294722886 AND published='1' LIMIT 1

69 (31.948089599609): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=211 ORDER BY `ordering`

70 (327.11029052734): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (249.14741516113): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (41.007995605469): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (28.848648071289): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (29.087066650391): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (30.994415283203): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (29.802322387695): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (58.889389038086): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (31.948089599609): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (33.855438232422): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (70.095062255859): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (31.948089599609): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (30.040740966797): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (34.093856811523): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (28.133392333984): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (37.908554077148): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (995.87440490723): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (65.088272094727): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (40.054321289062): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (!!!!! 2357.006072998): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

105 (305.17578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

106 (131.13021850586): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (76.055526733398): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (124.93133544922): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

109 (51.021575927734): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

110 (47.922134399414): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (901.93748474121): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (609.15946960449): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (439.88227844238): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (80.108642578125): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

115 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

116 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

117 (36.954879760742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

118 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

120 (84.161758422852): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

121 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

122 (313.04359436035): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

123 (!!!!! 57590.007781982): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

124 (722.88513183594): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722886 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722886 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 22815.227508545): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (106.0962677002): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (73.19450378418): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

128 (48.87580871582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803337 LIMIT 1

129 (77.009201049805): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

130 (46.014785766602): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294803276 LIMIT 1

131 (469.92301940918): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

132 (57.93571472168): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets_archive AS dp WHERE dp.id = 294803276 LIMIT 1

133 (54.836273193359): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

134 (43.153762817383): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294802958 LIMIT 1

135 (552.89268493652): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

136 (486.13548278809): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

137 (59.127807617188): SELECT name FROM jos_deeppockets WHERE id=211

138 (39.100646972656): SELECT name FROM jos_deeppockets WHERE id=211

139 (743.15071105957): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

140 (663.99574279785): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))211((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

141 (793.9338684082): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

142 (75.817108154297): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

143 (!!!!! 13463.020324707): TRUNCATE TABLE jos_trademed_module

144 (!!!!! 3416.0614013672): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

145 (106.0962677002): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294722886 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

146 (433.92181396484): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

147 (55.074691772461): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

148 (81.062316894531): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

149 (50.067901611328): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

150 (!!!!! 1347.0649719238): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

151 (66.041946411133): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

152 (48.87580871582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

153 (36.001205444336): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294722886 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294722886 AND type='deeppockets_item' AND published='1' LIMIT 1

154 (31.948089599609): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

155 (36.001205444336): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=211 or channel_id is null)

156 (38.14697265625): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

157 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

158 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294722886 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294722886 AND published='1' LIMIT 1

159 (41.007995605469): select jos_twitters.link from jos_twitters where cat=10

160 (29.087066650391): select jos_facebook.link from jos_facebook where cat=10

161 (28.848648071289): select jos_google_plus.link from jos_google_plus where cat=10

162 (36.001205444336): select jos_linkedin.link from jos_linkedin where cat=10

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