Impact of out-of-hospital cardiac arrest on outcome in STEMI patients treated with primary PCI

Abstract

Purpose: Pre-hospital ventricular arrhythmia is common in the acute phase of ST-elevation myocardial infarction (STEMI). We assessed the prognostic impact of out of hospital cardiac arrest (OHCA) in a non-selected STEMI patient population treated with primary percutaneous coronary intervention (PCI). Methods: Registry database of all individual STEMI patients admitted to our hospital during 2005-2010. Patients with OHCA were identified from the register, and their medical records were reviewed. Results: During the study period 4653 patients were admitted with STEMI. Information regarding OHCA was available in 4640 patients (99.7%). A total of 326 patients (7.0%) had OHCA. Patients with OHCA were younger (60.3±11.8 vs. 64.1±12.9, p 1) 17.5% vs. 7.7%, p<0.001. Angiography was performed in 97.5% of the patients. PCI was performed equally in both groups. In patients with OHCA LAD was more often the culprit artery (49.2% vs. 41.2%, p=0.003). In-hospital mortality was significantly higher among patients with OHCA (13.8% vs. 3.4%, p<0.001). However, in OHCA patients discharged alive one-year mortality was comparable to patients with no OHCA (3.9% vs. 3.7%, p=0.87). Conclusion: In a large non-selected STEMI patient population treated with primary PCI, OHCA was associated with higher in-hospital mortality but did not affect the long-term prognosis for those discharged alive.