Clinical and Angiographic Features of Patients With Out-of-Hospital Cardiac Arrest and Acute Myocardial Infarction

• Published in: Journal of the American College of Cardiology Vol. 76; no. 17; pp. 1934 - 1943
• Main Authors: Kosugi, Shumpei, Shinouchi, Kazuya, Ueda, Yasunori, Abe, Haruhiko, Sogabe, Taku, Ishida, Kenichiro, Mishima, Tsuyoshi, Ozaki, Tatsuhisa, Takayasu, Kohtaro, Iida, Yoshinori, Ohashi, Takuya, Toriyama, Chieko, Nakamura, Masayuki, Ueda, Yasuhiro, Sasaki, Shun, Matsumura, Mikiko, Iehara, Takashi, Date, Motoo, Ohnishi, Mitsuo, Uematsu, Masaaki, Koretsune, Yukihiro
• Format: Journal Article
• Language: English
• Published: United States 27.10.2020
• Subjects: Age Factors; Aged; Calcium Channel Blockers - therapeutic use; Coronary Angiography; Coronary Occlusion - complications; Coronary Occlusion - diagnostic imaging; Creatine Kinase, MB Form - blood; Female; Glomerular Filtration Rate; Hospital Mortality; Humans; Japan - epidemiology; Male; Middle Aged; Multivariate Analysis; Myocardial Infarction - epidemiology; Myocardial Infarction - therapy; Out-of-Hospital Cardiac Arrest - epidemiology; Out-of-Hospital Cardiac Arrest - therapy; Percutaneous Coronary Intervention; Retrospective Studies; Risk Factors; Tachycardia, Ventricular - epidemiology; Japan; chronic total occlusion; extracorporeal cardiopulmonary resuscitation; calcium-channel antagonist; acute myocardial infarction; out-of-hospital cardiac arrest
• ISSN: 0735-1097; 1558-3597
• DOI: 10.1016/j.jacc.2020.08.057

Sudden cardiac arrest is a serious complication of acute myocardial infarction (MI). Although in-hospital mortality from MI has decreased, the mortality of MI patients complicated with out-of-hospital cardiac arrest (OHCA) remains high. However, the features of acute MI patients with OHCA have not been well known. We sought to characterize the clinical and angiographic features of acute MI patients with OHCA comparing with those without OHCA. We retrospectively analyzed 480 consecutive patients with acute MI undergoing percutaneous coronary intervention. Patients complicated with OHCA were compared with patients without OHCA. Of the patients, 141 (29%) were complicated with OHCA. Multivariate analysis revealed that age (odds ratio [OR]: 0.8; 95% confidence interval [CI]: 0.7 to 0.9 per 5 years; p < 0.001), estimated glomerular filtration rate (OR: 0.8; 95% CI: 0.7 to 0.8 per 10 ml/min/1.73 m ; p < 0.001), peak creatine kinase-myocardial band (OR: 1.3; 95% CI: 1.2 to 1.4 per 10 U/l; p < 0.001), calcium-channel antagonists use (OR: 0.4; 95% CI: 0.2 to 0.7; p = 0.002), the culprit lesion at the left main coronary artery (OR: 5.3; 95% CI: 1.9 to 15.1; p = 0.002), and the presence of chronic total occlusion (OR: 2.9; 95% CI: 1.5 to 5.7; p = 0.001) were significantly associated with OHCA. Younger age, no use of calcium-channel antagonists, worse renal function, larger infarct size, culprit lesion in the left main coronary artery, and having chronic total occlusion were associated with OHCA.