Incidence and predictors of sudden cardiac arrest in the immediate post-percutaneous coronary intervention period for ST-elevation myocardial infarction: a single-center study.

Abstract

Data on the incidence, predictors, and outcomes of sudden cardiac arrest (SCA) in the immediate post-percutaneous coronary intervention (PCI) period for ST-elevation myocardial infarction (STEMI) are limited. The study aimed to investigate the trends and predictors of SCA occurring within 48 h post PCI for STEMI. We systematically reviewed data from the electronic medical records of 403 patients who underwent PCI for STEMI between January 2014 and December 2019. Trends in the incidence of SCA 48 h post PCI for STEMI were assessed using the Cochrane-Armitage test. Multivariable logistic regression was used to determine the predictors of SCA within 48 h post PCI for STEMI. Of the 403 patients who underwent PCI for STEMI, 44 (11%) had SCA within 48 h post PCI. The incidence of SCA within 48 h post PCI decreased from 22% in 2014 to 8% in 2019; P = 0.03. After adjusting for underlying confounding variables in the multivariable logistic regression models, out of hospital cardiac arrest [adjusted odds ratio (aOR), 23.9; confidence interval (CI), 10.2-56.1], left main coronary artery disease (aOR, 3.1; CI, 1.1-9.4), left main PCI (aOR, 6.6; CI: 1.4-31.7), new-onset heart failure (aOR, 2.0; CI, 4.3-9.4), and cardiogenic shock (aOR, 5.8; CI, 1.7-20.2) were statistically significant predictors of SCA within 48 h post PCI for STEMI. We identified essential factors associated with SCA within 48 h post PCI for STEMI. Future studies are needed to devise effective strategies to decrease the risk of SCA in the early post-PCI period.