Faculty Collaboration Database

Characteristics and outcomes in patients undergoing percutaneous coronary intervention following cardiac arrest (from the NCDR). Am J Cardiol 2014 Apr 01;113(7):1087-92

Date

02/12/2014

Pubmed ID

24513475

DOI

10.1016/j.amjcard.2013.12.014

Scopus ID

2-s2.0-84896039939 (requires institutional sign-in at Scopus site)   31 Citations

Abstract

Outcomes in patients with out-of-hospital cardiac arrest (CA) who undergo percutaneous coronary intervention (PCI) have been limited to small, mostly single-center studies. We compared patients who underwent PCI after CA included in the CathPCI Registry with those without CA. Patients with ST elevation were classified as ST-elevation myocardial infarction (STEMI); all other patients having PCI were classified as without STEMI. Patients with CA in each group were compared with the corresponding non-CA groups for baseline characteristics, angiographic findings, and outcomes. A total of 594,734 patients underwent PCI, of whom 114,768 had STEMI, including 9,375 (8.2%) had CA, and 479,966 had without STEMI, including 2,775 (0.6%) had CA. Patients with CA were similar in age to patients with non-CA, with a lower frequency of coronary disease risk factors and known coronary disease. On angiography, patients with CA were significantly more likely to have more complex lesions with worse baseline thrombolysis in myocardial infarction flow. Patients with CA were significantly more likely to have cardiogenic shock, both for patients with STEMI (51% vs 7.2%, respectively) and for patients without STEMI (38% vs 0.8%, respectively, both p<0.001). In-hospital mortality was substantially worse in patients with CA, for both patients with STEMI (24.9% vs 3.1%, respectively) and patients without STEMI (18.7% vs 0.4%, respectively). In conclusion, patients who underwent PCI after CA had more complex anatomy, more shock, and higher mortality. The substantially increased mortality in patients with CA has important implications for the development and regionalization of centers for CA.

Author List

Gupta N, Kontos MC, Gupta A, Dai D, Vetrovec GW, Roe MT, Messenger J

MESH terms used to index this publication - Major topics in bold

Aged
Coronary Angiography
Electrocardiography
Female
Follow-Up Studies
Heart Arrest
Hospital Mortality
Humans
Male
Middle Aged
Myocardial Infarction
Percutaneous Coronary Intervention
Prognosis
Registries
Retrospective Studies
Risk Factors
Survival Rate
Time Factors
United States