Abstract P412: The Effect of Targeted Therapeutic Management in ST-Elevation Myocardial Infarction Cardiac Arrest

Abstract

Introduction: ST-elevation myocardial infarction (STEMI) is a known cause of cardiac arrest (CA). Little is known about the impact of targeted therapeutic management in CA patients with STEMI (SCA). Our aim was to investigate the effect of TTM on SCA. Methods: This was a retrospective cohort study using the 2019 Nationwide Inpatient Sample database to identify admissions in adults with diagnoses of CA and STEMI. Regression models were adjusted for demographic variables. Primary outcome was mortality, and secondary outcomes were length of stay (LOS) and total charge in USD. Results: Out of 13895 admissions with SCA, 440 underwent TTM. Compared to Non-TTM-SCA cohort, TTM-SCA cohort had fewer females (18.18% vs 31.03,p<0.05), more males (81.82% vs 68.97,p<0.05), lower mean age (62.17 vs 64.57,p<0.05), more Native American (2.27% vs 0.63%,p<0.05), less South region hospitals (25.00% vs 39.95%,p<0.05), less acute respiratory failure with hypercapnia (0.47% vs 8.53%,p<0.05), acute respiratory failure with hypoxia (1.94% vs 38.90%,p<0.001), history of cardiac arrest (0.11% vs 0.61%,p<0.01), ventricular fibrillation (2.27% vs 50.59%,p<0.001), cerebral infarction (0.29% vs 4.28%,p<0.05), more alcohol abuse (12.50% vs 4.72%,p<0.001), and more persistent vegetative state (1.14% vs 0.15%,p<0.05). Compared to Non-TTM-SCA, TTM-SCA group had similar mortality rates (38.64% vs 42.96%,p=0.3940), mortality OR 1.04 (95%CI 0.66-1.62,p=0.869), higher mean LOS 10.69 vs 6.25 days (95%CI 2.39-6.17,p<0.001), and higher mean total hospitalization charge $238960.90 vs $179880.10 (95%CI 18772.87-98404.78,p<0.01). Conclusion: In SCA patients, TTM presence had no difference in mortality rate, odds of mortality, but had higher mean LOS and total hospitalization charge. TTM was associated with fewer females, more males, lower mean age, more Native Americans, less acute respiratory failure, history of cardiac arrest, ventricular fibrillation, cerebral infarction, and more alcohol abuse and persistent vegetative state.