The impact of emergent PCI on clinical outcome in AMI patients with out-of-hospital cardiac arrest: the Yamagata AMI registry

Abstract

Abstract Background Despite improvement of survival rate in acute myocardial infarction (AMI), out-of-hospital cardiac arrest (OHCA) is still devasting condition. The association of emergent percutaneous coronary intervention (PCI) with clinical outcome in AMI patients with OHCA has not yet been fully elucidated. Purpose The purpose of the present study was to examine the impact of emergent PCI on the clinical outcome in AMI patients with OHCA. Method and results We analyzed the data from Yamagata AMI registry among 2012–2017, which is multicenter surveillance conducted in all institution on Yamagata prefecture. Among 3332 AMI patients, there were 254 AMI patients with OHCA. The acute death rate was higher in AMI patients with OHCA than those without (70% vs. 13%, P<0.0001). Successful PCI was defined as TIMI grade flow III. AMI patients with OHCA were divided into three groups based on the PCI (successful PCI group, n=70; unsuccessful PCI group, n=14; and Non-PCI group, n=170). The acute death rates in successful PCI, unsuccessful PCI, and non-PCI group were 13%, 64%, 94%, respectively. Kaplan-Meier analysis demonstrated that acute death rate was the lowest in successful PCI group compared to other groups. Multivariate Cox proportional hazard regression analysis demonstrated that successful PCI was inversely associated with acute death after adjustment for confounding factors. The rate of thrombus aspiration was higher in successful PCI than in unsuccessful PCI group. Conclusion Successful PCI is of critical importance to prevent acute death in AMI patients with OHCA. Funding Acknowledgement Type of funding source: None