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

Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: A registry database study Show all authors Vijay Kunadian, Bilal Bawamia, Annette Maznyczka, ... First Published May 12, 2014 Research Article Download PDFPDF download for Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: A registry database study Article information Full Access Abstract Background: The mortality rate among patients undergoing primary percutaneous coronary intervention (PPCI) in the setting of cardiac arrest (CA) and whether the location where the patient sustains CA influences the outcome is not known in the contemporary era. Methods: Prospectively collected data at a tertiary cardiac centre on all patients undergoing PPCI for ST elevation myocardial infarction (STEMI) in the setting of CA was analysed. Results: In total, 484/4118 (11.8%) patients sustained CA during the study period. Of these, 91/484 (18.8%) sustained CA prior to ambulance arrival, the remainder occurred either after ambulance arrival or in hospital. The overall in-hospital mortality was 20.5% in this cohort. Those sustaining CA before ambulance arrival experienced the highest unadjusted mortality compared to those that had CA after ambulance arrival, in hospital and in the catheterisation laboratory (29.7% versus 12.0%, 16.1% and 23.8% respectively, p=0.03). Multiple logistic regression analysis showed that the following parameters are independent predictors of in-hospital mortality: age (odds ratio (OR) for each year increment of age 1.05; 95% confidence interval (CI) 1.02–1.08, p=0.0009); female gender (OR 2.42; 95% CI 1.17–4.99, p=0.0173); previous PCI (OR 7.59; 95% CI 1.72–33.53, p=0.0075); asystole/ electromechanical dissociation (EMD) (OR 13.43; 95% CI 5.34–33.80, p<0.0001); and patient location at arrest (OR 5.77 for before ambulance arrival; 95% CI 2.55–13.07, p<0.0001)