Long-term survival in patients presenting with STEMI complicated by out of hospital cardiac arrest.
Int J Cardiol Heart Vasc
; 22: 50-54, 2019 Mar.
Article
de En
| MEDLINE
| ID: mdl-30603662
ABSTRACT
BACKGROUND:
There is limited data regarding long-term survival in patients who present with STEMI and out of hospital cardiac arrest (OHCA).METHODS:
We prospectively analysed outcomes in 3521 consecutive patients who were diagnosed with STEMI and underwent primary percutaneous coronary intervention (PPCI) or coronary artery bypass surgery from 2004 to 2017. They were divided into two groups according to the presence of cardiac arrest (group I, patients with cardiac arrest; nâ¯=â¯156 group II, patients without cardiac arrest; nâ¯=â¯3365).RESULTS:
Patients with OHCA had higher in hospital mortality (27.7% vs 2.9%, pâ¯<â¯0.01), sustained VT or VF (44.6% vs 4.3%, pâ¯<â¯0.01) and cardiogenic shock (22.9% vs 6.8%, pâ¯<â¯0.01). 30-day mortality (excluding death within first 24â¯h) was also higher in the OHCA group (24.6% vs 3.3%, pâ¯<â¯0.01). There was no significant difference in recurrent AMI, TVR, stroke, major bleeds or new onset heart failure. After a mean follow-up of 18.6â¯months, mortality was higher in patients with OHCA (7.9% vs 3.8%, p 0.04). This was driven mainly by an increase in cardiac mortality (5% vs 1.1%, pâ¯<â¯0.01). OHCA was a significant predictor of mortality beyond 30â¯days (HR - 2.5, 95% CI 0.99-6.3). Kaplan-Meier curves and the log-rank test revealed that patients with OHCA had significantly lower survival (pâ¯<â¯0.01).CONCLUSIONS:
Patients with STEMI complicated by OHCA remain a high-risk group associated with high in hospital mortality. Beyond 30â¯days the occurrence of cardiac arrest was a significant predictor of all-cause and cardiac mortality.
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Type d'étude:
Prognostic_studies
Langue:
En
Journal:
Int J Cardiol Heart Vasc
Année:
2019
Type de document:
Article
Pays d'affiliation:
Australie