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Can the SYNTAX score predict mortality in patients with cardiac arrest?
Aykut Demirkıran1, Cihan Aydın1, Serhat Örün2
1Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Cardiology - Tekirdağ, Turkey.
Insights
Sudden cardiac arrest in ST-elevation myocardial infarction patients is predicted by high SYNTAX scores and the presence of chronic total occlusion. These factors indicate a higher risk of death following cardiac arrest.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Research
Background:
- Sudden cardiac death (SCD) or arrest is an unexpected cardiac event occurring rapidly.
- Acute ST-elevation myocardial infarction (STEMI) is a common cause of cardiac arrest.
- Understanding predictors of mortality in STEMI patients experiencing cardiac arrest is crucial.
Purpose of the Study:
- To investigate the association between coronary angiographic findings and cardiac death in STEMI patients with cardiac arrest.
- To identify specific angiographic features that predict mortality in this patient cohort.
Main Methods:
- Retrospective analysis of STEMI patients who experienced cardiac arrest.
- Assessment of coronary artery disease severity, chronic total occlusion, collateral circulation, and infarct-related artery blood flow.
- Comparison of angiographic parameters between cardiac death and survival groups.
Main Results:
- 161 deaths and 42 survivors were analyzed.
- Higher SYNTAX scores and the presence of chronic total occlusion were significantly associated with cardiac death (p=0.03 and p=0.02, respectively).
- A high SYNTAX score was an independent predictor of death (OR: 0.38).
Conclusions:
- Coronary chronic total occlusion and elevated SYNTAX scores are significant predictors of mortality in STEMI patients following cardiac arrest.
- These findings can aid in risk stratification and clinical decision-making for STEMI patients.
Objective:
Sudden cardiac death or arrest describes an unexpected cardiac cause-related death or arrest that occurs rapidly out of the hospital or in the emergency room. This study aimed to reveal the relationship between coronary angiographic findings and cardiac death secondary to acute ST-elevation myocardial infarction.
Materials And Methods:
Patients presenting with acute ST-elevation myocardial infarction complicated with cardiac arrest were included in the study. The severity of coronary artery disease, coronary chronic total occlusion, coronary collateral circulation, and blood flow in the infarct-related artery were recorded. Patients were divided into two groups, namely, deaths secondary to cardiac arrest and survivors of cardiac arrest.
Results:
A total of 161 cardiac deaths and 42 survivors of cardiac arrest were included. The most frequent (46.3%) location of the culprit lesion was on the proximal left anterior descending artery. The left-dominant coronary circulation was 59.1%. There was a difference in the SYNTAX score (16.3±3.8 vs. 13.6±1.9; p=0.03) and the presence of chronic total occlusion (19.2 vs. 0%; p=0.02) between survivors and cardiac deaths. A high SYNTAX score (OR: 0.38, 95%CI: 0.27-0.53, p<0.01) was determined as an independent predictor of death secondary to cardiac arrest.
Conclusion:
The chronic total occlusion presence and SYNTAX score may predict death after cardiac arrest secondary to ST-elevation myocardial infarction.
