Outcomes of ST-segment elevation myocardial infarction survivors complicated by out-of-hospital cardiac arrest: a single-center surveillance study. [Turk Kardiyol Dern Ars]
Turk Kardiyol Dern Ars. Ahead of Print: TKDA-32657 | DOI: 10.5543/tkda.2018.32657

Outcomes of ST-segment elevation myocardial infarction survivors complicated by out-of-hospital cardiac arrest: a single-center surveillance study.

Yalçın Velibey, Emre Can Parsova, Ufuk Sadık Ceylan, Özge Güzelburc, Koray Demir, Ufuk Yıldız, Aylin Şafak, Evliya Akdeniz, Tolga Sinan Güvenç, Emrah Bozbeyoğlu, Ahmet Ilker Tekkeşin
Siyami Ersek Thoracic and Cardiovascular Surgery Center, Training and Research Hospital, Department of Cardiology, Istanbul, Turkey


OBJECTIVE
The aim of the present study was to evaluate in-hospital and long-term outcomes of ST-segment elevation myocardial infarction (STEMI) survivors who experienced out-of-hospital cardiac arrest (OHCA) and underwent primary percutaneous coronary intervention (PCI) at a high-volume center within the STEMI network.

METHODS
The records of 2681 consecutive STEMI patients who underwent primary PCI between January 2009 and December 2014 at a single center in the STEMI network were retrospectively analyzed. Patients with STEMI complicated by OHCA were compared with a reference group of STEMI patients who did not experience OHCA.

RESULTS
Compared with STEMI survivors without OHCA (n=2587, 96.5%), the frequency of anterior myocardial infarction, duration of hospitalization, rate of in-hospital major adverse cardiovascular and cerebrovascular events, and the incidence of ischemic cerebrovascular disease and major bleeding during in-hospital follow-up were significantly greater in those with OHCA (n=94, 3.5%). The distribution of age and gender was similar between the 2 groups. The primary PCI success rate was high and was similar in both groups. In-hospital mortality was significantly higher (18.1% vs 1.5%; p<0.001) and survival at the 12th and 60th months was lower (74.5% vs 96.5%; p<0.001 and 71.3% vs 93.7%; p<0.001) in STEMI survivors with OHCA. OHCA was an independent predictor for in-hospital mortality (Odds ratio [OR]: 3.413; 95% confidence interval [CI]: 1.534–7.597; p=0.003) and all-cause mortality at 60 months (OR: 3.285; 95% CI: 2.020–5.340; p<0.001).

CONCLUSION
Mortality was high in patients with STEMI complicated by OHCA, even though PCI was performed with the same success rate seen in patients without OHCA.

Keywords: ST-segment elevation myocardial infarction, out-of-hospital cardiac arrest, primary percutaneous coronary intervention, short and long term survival

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Corresponding Author: Yalçın Velibey, Türkiye
© Copyright 2018 Archives of the Turkish Society of Cardiology
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