Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest
Abstract Background Although short-term mortality of acute myocardial infarction (AMI) has decreased dramatically in the past few decades, sudden cardiac arrest remains a serious complication. The aim of the study was to assess the clinical characteristics and predictors of prognosis in AMI patients...
| Main Authors: | , , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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BMC
2022-04-01
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| Series: | BMC Cardiovascular Disorders |
| Subjects: | |
| Online Access: | https://doi.org/10.1186/s12872-022-02628-3 |
| _version_ | 1818147407720873984 |
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| author | Taketo Sonoda Hideki Wada Manabu Ogita Daigo Takahashi Ryota Nishio Kentaro Yasuda Mitsuhiro Takeuchi Shoichiro Yatsu Jun Shitara Shuta Tsuboi Tomotaka Dohi Satoru Suwa Katsumi Miyauchi Tohru Minamino |
| author_facet | Taketo Sonoda Hideki Wada Manabu Ogita Daigo Takahashi Ryota Nishio Kentaro Yasuda Mitsuhiro Takeuchi Shoichiro Yatsu Jun Shitara Shuta Tsuboi Tomotaka Dohi Satoru Suwa Katsumi Miyauchi Tohru Minamino |
| author_sort | Taketo Sonoda |
| collection | DOAJ |
| description | Abstract Background Although short-term mortality of acute myocardial infarction (AMI) has decreased dramatically in the past few decades, sudden cardiac arrest remains a serious complication. The aim of the study was to assess the clinical characteristics and predictors of prognosis in AMI patients who experienced out-of-hospital cardiac arrest (OHCA). Methods We retrospectively registered consecutive AMI patients who were treated with emergency percutaneous coronary intervention (PCI) between 2004 and 2017. Clinical characteristics and outcomes were compared between patients with OHCA and those without OHCA. Results Among 2101 AMI patients, 95 (4.7%) presented with OHCA. Younger age (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.93–0.97; p < 0.0001), absence of diabetes mellitus (OR, 0.51; 95% CI, 0.30–0.85; p = 0.01) or dyslipidemia (OR, 0.56; 95% CI, 0.36–0.88; p = 0.01), left main trunk (LMT) or left anterior descending artery (LAD) as the culprit lesion (OR, 3.26; 95% CI, 1.99–5.33; p < 0.0001), and renal deficiency (OR, 3.64; 95% CI, 2.27–5.84; p < 0.0001) were significantly associated with incidence of OHCA. Thirty-day mortality was 32.6% in patients with OHCA and 4.5% in those without OHCA. Multivariate logistic analysis revealed LMT or LAD as the culprit lesion (OR, 12.18; 95% CI, 2.27–65.41; p = 0.004), glucose level (OR, 1.01; 95% CI, 1.00–1.01; p = 0.01), and renal deficiency (OR, 3.35; 95% CI, 1.07–10.53; p = 0.04) as independent predictors of 30-day mortality among AMI patients with OHCA. Conclusions In patients with AMI who underwent emergency PCI, 30-day mortality was six times greater in those having presented initially with OHCA compared with those without OHCA. Younger age, absence of diabetes mellitus or dyslipidemia, LMT or LAD as the culprit lesion, and renal deficiency were independent predictors of OHCA. OHCA patient with higher blood glucose level on admission, LMT or LAD as the culprit lesion, or renal deficiency showed worse clinical outcomes. |
| first_indexed | 2024-12-11T12:34:46Z |
| format | Article |
| id | doaj.art-4476b01dc6d448409cd3a37d123b0050 |
| institution | Directory Open Access Journal |
| issn | 1471-2261 |
| language | English |
| last_indexed | 2024-12-11T12:34:46Z |
| publishDate | 2022-04-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Cardiovascular Disorders |
| spelling | doaj.art-4476b01dc6d448409cd3a37d123b00502022-12-22T01:07:10ZengBMCBMC Cardiovascular Disorders1471-22612022-04-012211910.1186/s12872-022-02628-3Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrestTaketo Sonoda0Hideki Wada1Manabu Ogita2Daigo Takahashi3Ryota Nishio4Kentaro Yasuda5Mitsuhiro Takeuchi6Shoichiro Yatsu7Jun Shitara8Shuta Tsuboi9Tomotaka Dohi10Satoru Suwa11Katsumi Miyauchi12Tohru Minamino13Department of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine and Biology, Juntendo University Graduate School of MedicineDepartment of Cardiovascular Medicine, Juntendo University Shizuoka HospitalDepartment of Cardiovascular Medicine and Biology, Juntendo University Graduate School of MedicineDepartment of Cardiovascular Medicine and Biology, Juntendo University Graduate School of MedicineAbstract Background Although short-term mortality of acute myocardial infarction (AMI) has decreased dramatically in the past few decades, sudden cardiac arrest remains a serious complication. The aim of the study was to assess the clinical characteristics and predictors of prognosis in AMI patients who experienced out-of-hospital cardiac arrest (OHCA). Methods We retrospectively registered consecutive AMI patients who were treated with emergency percutaneous coronary intervention (PCI) between 2004 and 2017. Clinical characteristics and outcomes were compared between patients with OHCA and those without OHCA. Results Among 2101 AMI patients, 95 (4.7%) presented with OHCA. Younger age (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.93–0.97; p < 0.0001), absence of diabetes mellitus (OR, 0.51; 95% CI, 0.30–0.85; p = 0.01) or dyslipidemia (OR, 0.56; 95% CI, 0.36–0.88; p = 0.01), left main trunk (LMT) or left anterior descending artery (LAD) as the culprit lesion (OR, 3.26; 95% CI, 1.99–5.33; p < 0.0001), and renal deficiency (OR, 3.64; 95% CI, 2.27–5.84; p < 0.0001) were significantly associated with incidence of OHCA. Thirty-day mortality was 32.6% in patients with OHCA and 4.5% in those without OHCA. Multivariate logistic analysis revealed LMT or LAD as the culprit lesion (OR, 12.18; 95% CI, 2.27–65.41; p = 0.004), glucose level (OR, 1.01; 95% CI, 1.00–1.01; p = 0.01), and renal deficiency (OR, 3.35; 95% CI, 1.07–10.53; p = 0.04) as independent predictors of 30-day mortality among AMI patients with OHCA. Conclusions In patients with AMI who underwent emergency PCI, 30-day mortality was six times greater in those having presented initially with OHCA compared with those without OHCA. Younger age, absence of diabetes mellitus or dyslipidemia, LMT or LAD as the culprit lesion, and renal deficiency were independent predictors of OHCA. OHCA patient with higher blood glucose level on admission, LMT or LAD as the culprit lesion, or renal deficiency showed worse clinical outcomes.https://doi.org/10.1186/s12872-022-02628-3Acute myocardial infarctionCardiac arrestPercutaneous coronary intervention |
| spellingShingle | Taketo Sonoda Hideki Wada Manabu Ogita Daigo Takahashi Ryota Nishio Kentaro Yasuda Mitsuhiro Takeuchi Shoichiro Yatsu Jun Shitara Shuta Tsuboi Tomotaka Dohi Satoru Suwa Katsumi Miyauchi Tohru Minamino Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest BMC Cardiovascular Disorders Acute myocardial infarction Cardiac arrest Percutaneous coronary intervention |
| title | Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest |
| title_full | Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest |
| title_fullStr | Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest |
| title_full_unstemmed | Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest |
| title_short | Clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out-of-hospital cardiac arrest |
| title_sort | clinical features and predictors of outcome in patients with acute myocardial infarction complicated by out of hospital cardiac arrest |
| topic | Acute myocardial infarction Cardiac arrest Percutaneous coronary intervention |
| url | https://doi.org/10.1186/s12872-022-02628-3 |
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