Out-of-Hospital Cardiac Arrest Does Not Affect Post-Discharge Survival in Patients With Acute Myocardial Infarction

Abstract

Background: Acute myocardial infarction (AMI) patients complicated by out-of-hospital cardiac arrest (OHCA) show poor in-hospital outcomes. However, the post-discharge outcomes of survivors of OHCA have not been well studied. Methods and Results: Data for patients admitted to The Jikei University Kashiwa Hospital with AMI between April 2012 and March 2020 were examined retrospectively. The Jikei University Kashiwa Hospital is a tertiary emergency medical facility, so the frequency of OHCA in this hospital is higher than in an ordinary AMI population. Of 803 patients, 92 (11.5%) were complicated by OHCA. Of the 92 OHCA patients, 37 died in hospital, compared with 45 of 711 non-OHCA patients who died in hospital (P<0.001). OHCA was more frequent in men than in women. The estimated glomerular filtration rate was lower in those with than without OHCA. Long-term mortality was evaluated in patients discharged alive and followed-up at an outpatient clinic (n=635; median follow-up period 607 days). The long-term post-discharge mortality was comparable between AMI patients with and without OHCA. Conclusions: The post-discharge mortality of AMI patients with OHCA was comparable that of patients without OHCA.

Long-term Survival After Out-of-Hospital Cardiac Arrest

“…After removing duplicates (n = 5296), the remaining 10 051 records were screened on titles and abstracts. Of the resulting 854 full-text articles, 38 studies were included in the final qualitative and quantitative analysis. A total of 21 studies with 11 800 patients were used for KM-based meta-analysis, whereas 33 studies with 16 933 patients were used for aggregate data meta-analysis.…”

“…Of the resulting 854 full-text articles, 38 studies were included in the final qualitative and quantitative analysis. A total of 21 studies with 11 800 patients were used for KM-based meta-analysis, whereas 33 studies with 16 933 patients were used for aggregate data meta-analysis. eFigure 1 in the Supplement outlines the study selection process.…”

“…The characteristics of the included studies are given in Table 1, and a detailed summary of the included studies can be found in eTable 1 in the Supplement. The studies were conducted on 4 continents: Europe (n = 20), North America (n = 8), Asia (n = 6), and Australia (n = 4).…”

“…Risk of bias was assessed for all included 38 studies (eTable 2 in the Supplement). Thirteen studies had a low risk of bias, and 21 studies had a moderate risk of bias from reporting outcomes of a selected subgroup of patients with OHCA.…”

One-Year Follow-Up of Patients Admitted for Emergency Coronary Angiography after Resuscitated Cardiac Arrest

“…Therefore, for patients without any neurologic sequelae at discharge, apparition of a new cardiac event or recurrence of initial arrhythmia seems not to be the main issue. In a recent study, Kubota et al showed that the post-discharge mortality of ACS (STEMI or NSTEMI) patients with OHCA was comparable to that of patients without OHCA [41].…”