Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/11386
Title: Survival in patients with myocardial infarction complicated by out-of-hospital cardiac arrest undergoing emergency percutaneous coronary intervention.
Authors: Lim, Han S;Stub, Dion;Ajani, Andrew E;Andrianopoulos, Nick;Reid, Christopher M;Charter, Kerrie;Black, Alexander;Smith, Karen;New, Gishel;Chan, William;Lim, Chris C S;Farouque, Omar;Shaw, James;Brennan, Angela L;Duffy, Stephen J;Clark, David J
Affiliation: Department of Cardiology, Austin Health, Melbourne, Australia
Issue Date: 30-Nov-2011
Citation: International Journal of Cardiology 2011; 166(2): 425-30
Abstract: We sought to evaluate the clinical outcomes of patients with myocardial infarction (MI) complicated by out-of-hospital cardiac arrest (OHCA) undergoing percutaneous coronary intervention (PCI).Controversy remains regarding the benefit of early PCI in patients with MI complicated by OHCA.We analyzed the outcomes of 88 consecutive patients presenting with MI complicated by OHCA compared to 5101 patients with MI without OHCA who underwent PCI from the Melbourne Interventional Group registry between 2004 and 2009.Patients with OHCA had a higher proportion of ST-elevation MI presentations (90.9% vs. 50%, p<0.01) and were more likely to be to be in cardiogenic shock (38.6% vs. 4.6%, p<0.01). Procedural success was similar in the two groups (95.5% OHCA vs. 96.5% non-OHCA MI cohort, p=0.65). In-hospital, 30-day, and 1-year survival in the OHCA cohort versus the non-OHCA MI cohort were 62.5% vs. 97.2% (p<0.01), 61.4% vs. 96.5% (p<0.01), and 60.2% vs. 94.2% (p<0.01), respectively. Within the OHCA cohort, presentation with cardiogenic shock (OR 7.2, 95% CI: 2.7-18.8; p<0.01) was strongly associated with in-hospital mortality. Importantly, 1-year survival of patients discharged alive from hospital was similar between the two groups (96% vs. 97% p=0.8).Patients with MI complicated by OHCA remain a high-risk group associated with high mortality. However, high procedural success rates similar to non-OHCA patients can be attained. Survival rates better than previously reported were observed with an emergent PCI approach, with 1-year survival comparable to a non-OHCA cohort if patients survive to hospital discharge.
Internal ID Number: 22133465
URI: http://ahro.austin.org.au/austinjspui/handle/1/11386
DOI: 10.1016/j.ijcard.2011.10.131
URL: http://www.ncbi.nlm.nih.gov/pubmed/22133465
Type: Journal Article
Subjects: Aged
Cohort Studies
Emergency Medical Services.methods
Female
Follow-Up Studies
Humans
Male
Middle Aged
Myocardial Infarction.diagnosis.mortality.surgery
Out-of-Hospital Cardiac Arrest.diagnosis.mortality.surgery
Percutaneous Coronary Intervention.mortality
Registries
Survival Rate.trends
Treatment Outcome
Appears in Collections:Journal articles

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