Outcome of patients with ST-elevation myocardial infarction complicated by pre-hospital cardiac arrest underwent emergency percutaneous coronary intervention.
- Author:
Wei PAN
1
;
Shu-sen YANG
;
Lan-feng WANG
;
Yan-ming SUN
;
Zhu-qin LI
;
Li-jun ZHOU
;
Yue LI
;
Wei-min LI
Author Information
- Publication Type:Journal Article
- MeSH: Adult; Aged; Angioplasty, Balloon, Coronary; Emergency Treatment; Female; Heart Arrest; complications; therapy; Hospital Mortality; Humans; Male; Middle Aged; Myocardial Infarction; complications; mortality; therapy; Treatment Outcome
- From: Chinese Journal of Cardiology 2010;38(10):875-879
- CountryChina
- Language:Chinese
-
Abstract:
OBJECTIVETo evaluate the outcome of ST-elevation acute myocardial infarction (STEMI) patients complicated pre-hospital cardiac arrest underwent percutaneous coronary intervention (PCI).
METHODSFrom September 2004 to November 2008, 1446 consecutive patients with acute STEMI underwent PCI in our department. 49 out of 1446 patients complicated by pre-hospital cardiac arrest. Clinical outcome including total mortality, adverse cardiac events, stroke and bleeding events during the hospitalization period and within 1 year after discharge was compared between patients with or without pre-hospital cardiac arrest.
RESULTSPCI success rate was similar (85.7% vs. 88.8%, P = 0.497) while the incidence of in-hospital cardiogenic shock 22.4% vs. 3.0%, P < 0.001 and cardiac arrest (44.9% vs. 5.9%, P < 0.001) and in-hospital mortality (36.7% vs. 2.0%, P < 0.001) were significantly higher in patients with pre-hospital cardiac arrest than patients without pre-hospital cardiac arrest. Time from symptom onset to emergency treatment, asystole as initial rhythm, Glasgow coma scale (GCS ≤ 7) and cardiogenic shock on admission were independent risk factors of in-hospital death in patients with pre-hospital cardiac arrest. During follow up, incidences of overall mortality, re-infarction, revascularization and stroke were similar between the two groups.
CONCLUSIONSSTEMI patients with pre-hospital cardiac arrest undergoing emergency PCI are facing higher risk of cardiogenic shock and cardiac arrest and higher in-hospital mortality compared to those without pre-hospital cardiac arrest. However, the post-hospital discharge outcome was similar between the two groups.