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Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: a registry database

Vijay Kunadian1, Bilal Bawamia2, Annette Maznyczka3

  • 1Institute of Cellular Medicine, Newcastle University, UK Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, UK vijay.kunadian@newcastle.ac.uk.

European Heart Journal. Acute Cardiovascular Care
|May 14, 2014
PubMed

Insights

In-hospital mortality is high for patients undergoing primary percutaneous coronary intervention (PPCI) after cardiac arrest (CA). Arresting before ambulance arrival significantly increases mortality risk in these critical cardiac patients.

Area of Science:

  • Cardiology
  • Emergency Medicine
  • Clinical Research

Background:

  • Assessing contemporary mortality rates for primary percutaneous coronary intervention (PPCI) in patients experiencing cardiac arrest (CA).
  • Investigating the impact of cardiac arrest location on patient outcomes during PPCI.

Purpose of the Study:

  • To determine the in-hospital mortality rate among patients undergoing PPCI following cardiac arrest.
  • To evaluate if the location of cardiac arrest influences outcomes in patients receiving PPCI.

Main Methods:

  • Analysis of prospectively collected data from a tertiary cardiac center.
  • Inclusion of all patients undergoing PPCI for ST-elevation myocardial infarction (STEMI) in the setting of CA.
  • Statistical analysis including multiple logistic regression to identify independent predictors of mortality.

Main Results:

  • 11.8% of STEMI patients experienced CA during the study period; overall in-hospital mortality was 20.5%.
  • Patients experiencing CA before ambulance arrival had the highest unadjusted mortality (29.7%).
  • Independent predictors of mortality included older age, female gender, previous PCI, asystole/EMD, and arrest location (before ambulance arrival).

Conclusions:

  • In-hospital mortality remains a significant concern for patients undergoing PPCI after cardiac arrest.
  • Patients who experience cardiac arrest prior to ambulance arrival face particularly high mortality risks.
Abstract

Keywords:
Cardiac arrestasystolemortalityprimary percutaneous coronary intervention

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