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

Kunadian, Vijay; Bawamia, Bilal; Maznyczka, Annette; Zaman, Azfar; Qiu, Weiliang

doi:10.1177/2048872614534079

Cited by 12 publications

(9 citation statements)

References 38 publications

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“…Out of hospital cardiac arrest associated with acute myocardial infarction (MI) occurs in 8% to 10% of acute MI patients . Although there have been significant improvements in outcomes, patients with cardiac arrest continue to have a high‐mortality despite aggressive treatment, including frequent use of urgent revascularization …”

Section: Introductionmentioning

confidence: 99%

Association of acute myocardial infarction cardiac arrest patient volume and in‐hospital mortality in the United States: Insights from the National Cardiovascular Data Registry Acute Coronary Treatment And Intervention Outcomes Network Registry

Kontos

Fordyce

Chen

et al. 2019

Clinical Cardiology

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Background Little is known about how differences in out of hospital cardiac arrest patient volume affect in‐hospital myocardial infarction (MI) mortality. Hypothesis Hospitals accepting cardiac arrest transfers will have increased hospital MI mortality. Methods MI patients (ST elevation MI [STEMI] and non‐ST elevation MI [NSTEMI]) in the Acute Coronary Treatment Intervention Outcomes Network Registry were included. Hospital variation of cardiac arrest and temporal trend of the proportion of cardiac arrest MI patients were explored. Hospitals were divided into tertiles based on the proportion of cardiac arrest MI patients, and association between in‐hospital mortality and hospital tertiles of cardiac arrest was compared using logistic regression adjusting for case mix. Results A total of 252 882 patients from 224 hospitals were included, of whom 9682 (3.8%) had cardiac arrest (1.6% of NSTEMI and 7.5% of STEMI patients). The proportion of MI patients who had cardiac arrest admitted to each hospital was relatively low (median 3.7% [25th, 75th percentiles: 3.0%, 4.5%]).with a range of 4.2% to 12.4% in the high‐volume tertiles. Unadjusted in‐hospital mortality increased with tertile: low 3.8%, intermediate 4.6%, and high 4.7% ( P < 0.001); this was no longer significantly different after adjustment (intermediate vs high tertile odds ratio (OR) = 1.02; 95% confidence interval [0.90‐1.16], low vs high tertile OR = 0.93 [0.83, 1.05]). Conclusions The proportion of MI patients who have cardiac arrest is low. In‐hospital mortality among all MI patients did not differ significantly between hospitals that had increased proportions of cardiac arrest MI patients. For most hospitals, overall MI mortality is unlikely to be adversely affected by treating cardiac arrest patients with MI.

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Section: Introductionmentioning

confidence: 99%

Association of acute myocardial infarction cardiac arrest patient volume and in‐hospital mortality in the United States: Insights from the National Cardiovascular Data Registry Acute Coronary Treatment And Intervention Outcomes Network Registry

Kontos

Fordyce

Chen

et al. 2019

Clinical Cardiology

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“…The Kunadian et al study and the Dumas et al studies are both retrospective studies examining the utilization of PCI for OHCA in United Kingdom and Parisian population respectively [1] [3]. The current study examined a large cohort of OHCA patients from the Nationwide Inpatient Service (NIS) database to compare demographic and clinical differences between those who received PCI and those who did not, and the impact of PCI on survival.…”

Section: Introductionmentioning

confidence: 99%

“…The Global Registry of Acute Coronary Events (GRACE) Registry found that cardiac arrest was an independent prognostic factor for in-hospital mortality [3] [7]. Despite advancements in resuscitation guidelines and techniques, survival rates remain low for both OHCA (9.5%) and IHCA (23.9%) [3] [6] [8] [9].…”

Section: Introductionmentioning

confidence: 99%

“…Over 350,000 people experience OHCA each year in the United States (US), while an additional 200,000 patients experience in-hospital cardiac arrest (IHCA) [4] [5] [6]. The Global Registry of Acute Coronary Events (GRACE) Registry found that cardiac arrest was an independent prognostic factor for in-hospital mortality [3] [7]. Despite advancements in resuscitation guidelines and techniques, survival rates remain low for both OHCA (9.5%) and IHCA (23.9%) [3] [6] [8] [9].…”

Section: Introductionmentioning

confidence: 99%

“…Out-of-hospital cardiac arrest (OHCA) is a leading cause of death in the industrialized world [1] [2] [3]. Over 350,000 people experience OHCA each year in the United States (US), while an additional 200,000 patients experience in-hospital cardiac arrest (IHCA) [4] [5] [6].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Percutaneous Coronary Intervention Reduces Mortality in Out-of-Hospital Cardiac Arrest after Acute Coronary Syndrome: An Outcomes-Based Study from the Nationwide Inpatient Sample Database

Lau¹,

Pourriahi²,

Ward³

et al. 2017

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Intra-arrest percutaneous coronary intervention: a case series

Balevski

Markota

Purg

et al. 2015

Wien Klin Wochenschr

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In patients with refractory cardiac arrest presumably from acute coronary occlusion, primary percutaneous coronary intervention (PPCI) may provide an opportunity for revascularisation and, subsequently, return of spontaneous circulation. We present our experience from a 24/7 primary percutaneous coronary intervention centre serving a population of approximately 800,000 individuals. A retrospective analysis was performed in patients with cardiac arrest treated from July 2011 to January 2014. Inclusion criteria were cardiac arrest and emergency coronary angiography performed during on-going external cardiopulmonary resuscitation (CPR). Course of treatment was analysed to outline the reasons for poor survival. Eight patients met the inclusion criteria; six (75 %) were male, and the mean age was 63 ± 16 years. Revascularisation under continuous cardiopulmonary resuscitation was achieved in all eight patients. Sustained return of spontaneous circulation was achieved in two patients (25 %). Both patients had poor neurological outcome (cerebral performance category 4), and both died within 3 months. We identified total duration of cardiopulmonary resuscitation (90.5 ± 33.3 min), lack of prehospital mechanical cardiopulmonary resuscitation devices and lack of extra-corporeal life support devices as the most likely reasons contributing to poor survival.

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

Abstract: In conclusion, in-hospital mortality remains high among patients undergoing PPCI in the context of CA, particularly among those that arrest prior to ambulance arrival.

Cited by 12 publications

References 38 publications

Association of acute myocardial infarction cardiac arrest patient volume and in‐hospital mortality in the United States: Insights from the National Cardiovascular Data Registry Acute Coronary Treatment And Intervention Outcomes Network Registry

Association of acute myocardial infarction cardiac arrest patient volume and in‐hospital mortality in the United States: Insights from the National Cardiovascular Data Registry Acute Coronary Treatment And Intervention Outcomes Network Registry

Percutaneous Coronary Intervention Reduces Mortality in Out-of-Hospital Cardiac Arrest after Acute Coronary Syndrome: An Outcomes-Based Study from the Nationwide Inpatient Sample Database

Intra-arrest percutaneous coronary intervention: a case series

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