Short- and long-term outcomes of out-of-hospital cardiac arrest following ST- elevation myocardial infarction managed with percutaneous coronary intervention
Resuscitation Mar 26, 2020
Dawson LP, et al. - Among ST-elevation myocardial infarction (STEMI) patients with and without out-of-hospital cardiac arrest (OHCA) treated with percutaneous coronary intervention (PCI), researchers explored differences in characteristics as well as very long-term outcomes. For this purpose, they used the multi-centre Melbourne Interventional Group registry to obtain data from 12,637 PCI patient procedures for STEMI. Younger age, male gender, previous valve surgery, multi-vessel disease, LAD culprit, small vessel diameter, and renal impairment on presentation were the factors that showed an independent link with OHCA presentation. Lower procedural success, higher rates of bleeding and stroke, larger infarct size (measured by peak CK), and higher 30-day mortality were observed among patients with OHCA. Independent link with 30-day mortality was shown by factors such as cardiogenic shock, renal impairment and lower ejection fraction. Overall, a high short-term mortality was noted in OHCA. Also, it was observed that OHCA preceded an increasing proportion of STEMI PCI cases. An excellent long-term prognosis was observed among 30-day survivors.
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