Prognostic implication of out of hospital cardiac arrest in patients with cardiogenic shock and acute myocardial infarction

Ostenfeld, Sarah; Lindholm, Matias Greve; Kjærgaard, Jesper; Hassager, Christian

doi:10.1016/j.resuscitation.2014.03.039

Cited by 7 publications

(9 citation statements)

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“…We observed that patients with AMICS and OHCA undergoing revascularization had lower 30‐day mortality than patients without OHCA (6% absolute reduction in mortality). This topic is poorly studied, and an earlier study from one of the participating centres showed the opposite result, highlighting the need for further studies . Consistent with previous findings, female sex was associated with worse prognosis in crude analysis, but adjusting for age and symptom to revascularization delay diminished the trend suggesting that female sex is not an independent risk factor in AMICS .…”

Section: Discussionsupporting

confidence: 66%

“…This topic is poorly studied, and an earlier study from one of the participating centres showed the opposite result, highlighting the need for further studies. 23 previous findings, female sex was associated with worse prognosis in crude analysis, but adjusting for age and symptom to revascularization delay diminished the trend suggesting that female sex is not an independent risk factor in AMICS. 24 We also observed a change in timing of shock occurrence with only 6.9% of patients developing shock > 12 h after admission in 2017 compared to 14.8% in 2010.…”

Section: Discussioncontrasting

confidence: 51%

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Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Helgestad

Josiassen

Hassager

et al. 2019

European J of Heart Fail

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110

132

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Aim We sought to describe the contemporary annual incidence of cardiogenic shock (CS) following acute myocardial infarction (AMICS), the proportion of patients developing CS following ST‐elevation myocardial infarction (STEMI), and other temporal changes in AMICS in Denmark between 2010 and 2017. Methods and results Medical records of patients suspected of having AMICS during 2010–2017 were reviewed to identify consecutive patients with AMICS in a cohort corresponding to two‐thirds of the Danish population. Due to changes in recruitment area over the study period, population‐based incidence could only be calculated from 2012 to 2017. A total of 1716 patients with AMICS were identified and an increase in the annual incidence was observed, from a nadir 65.3 per million person‐years in 2013 to 80.0 per million person‐years in 2017 (P‐value for trend < 0.001). This trend corresponded to an increase in patients with non‐STEMI and a decrease in patients developing CS after STEMI (10.0–6.6%, P‐value for trend < 0.001) Also, mean arterial blood pressure at the time of AMICS was lower (63 ± 11 mmHg to 61 ± 13 mmHg, P‐value for trend = 0.001) and the frequency of patients with left ventricular ejection fraction ≤ 30% increased (61.8%–71.4%, P‐value for trend = 0.004). The annual 30‐day mortality during the study period remained unchanged at about 50%. Conclusion The incidence rate of AMICS increased in the Danish population between 2012 and 2017. Fewer patients with STEMI developed CS, and haemodynamic severity of CS increased during the study period; however, survival rates remained unchanged.

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Section: Discussionsupporting

confidence: 66%

Section: Discussioncontrasting

confidence: 51%

Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Helgestad

Josiassen

Hassager

et al. 2019

European J of Heart Fail

Self Cite

110

132

View full text Add to dashboard Cite

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“…However, Ostenfeld et al reported that OHCA was not an independent predictor of death in patients with cardiogenic shock caused by ACS. 41 The effect of OHCA on patients' outcome has to be investigated in a further analysis. In the present study, eGFR was a strong predictor of 30-day mortality.…”

Section: Discussionmentioning

confidence: 99%

Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan　– Results From the Japanese Circulation Society Cardiovascular Shock Registry –

Ueki

Mohri

Matoba

et al. 2016

Circ J

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“…However, in a study on 248 consecutive patients with acute myocardial infarction and cardiogenic shock, OHCA was not an independent predictor of death [12], while in another 5-year follow-up study on 3670 STEMI patients, cardiogenic shock at the initial stage was associated with a higher mortality risk at one year [13]. These studies prove that the high mortality associated with CS and cardiac arrest is mainly caused by the deterioration of the clinical status leading to CS and not by the cardiac arrest, which once resuscitated, is not associated with a significantly higher risk in the long term [14].…”

Section: Discussionmentioning

confidence: 89%

Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest

Barcan

Chițu

Benedek

et al. 2016

The Journal of Critical Care Medicine

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Introduction: In patients with out-of-hospital cardiac arrest (OHCA) complicating an ST-segment elevation myocardial infarction (STEMI), the survival depends largely on the restoration of coronary flow in the infarct related artery. The aim of this study was to determine clinical and angiographic predictors of in-hospital mortality in patients with OHCA and STEMI, successfully resuscitated and undergoing primary percutaneous intervention (PCI). Methods: From January 2013 to July 2015, 78 patients with STEMI presenting OHCA, successfully resuscitated, transferred immediately to the catheterization unit and treated with primary PCI, were analyzed. Clinical, laboratory and angiographic data were compared in 28 non-survivors and 50 survivors. Results:The clinical baseline characteristics of the study population showed no significant differences between the survivors and non-survivors in respect to age (p=0.06), gender (p=0.8), the presence of hypertension (p=0.4), dyslipidemia (p=0.09) obesity (p=1), smoking status (p=0.2), presence of diabetes (p=0.2), a clinical history of acute myocardial infarction (p=0.7) or stroke (p=0.17). Compared to survivors, the non-survivor group exhibited a significantly higher incidence of cardiogenic shock (50% vs 24%, p=0.02), renal failure (64.3% vs 30.0%, p=0.004) and anaemia (35.7% vs 12.0%, p=0.02). Three-vessel disease was significantly higher in the non-survivor group (42.8% vs. 20.0%, p=0.03), while there was a significantly higher percentage of TIMI 3 flow postPCI in the infarct-related artery in the survivor group (80.% vs. 57.1%, p=0.03). The time from the onset of symptoms to revascularization was significantly higher in patients who died compared to those who survived (387.5 +/-211.3 minutes vs 300.8 +/-166.1 minutes, p=0.04), as was the time from the onset of cardiac arrest to revascularization (103.0 +/-56.34 minutes vs 67.0 +/-44.4 minutes, p=0.002). Multivariate analysis identified the presence of cardiogenic shock (odds ratio [OR]: 3.17, p=0.02), multivessel disease (OR: 3.0, p=0.03), renal failure (OR: 4.2, p=0.004), anaemia (OR: 4.07, p=0.02), need for mechanical ventilation >48 hours (OR: 8.07, p=0.0002) and a duration of stay in the ICU longer than 5 days (OR: 9.96, p=0.0002) as the most significant independent predictors for mortality in patients with OHCA and STEMI. Conclusion: In patients surviving an OHCA in the early phase of a myocardial infarction, the presence of cardiogenic shock, renal failure, anaemia or multivessel disease, as well as a longer time from the onset of symptoms or of cardiac arrest to revascularization, are independent predictors of mortality. However, the most powerful predictor of death is the duration of stay in the ICU and the requirement of mechanical ventilation for more than forty-eight hours.

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Prognostic implication of out of hospital cardiac arrest in patients with cardiogenic shock and acute myocardial infarction

Cited by 7 publications

References 0 publications

Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan　– Results From the Japanese Circulation Society Cardiovascular Shock Registry –

Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest

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Prognostic implication of out of hospital cardiac arrest in patients with cardiogenic shock and acute myocardial infarction

Cited by 7 publications

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Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Temporal trends in incidence and patient characteristics in cardiogenic shock following acute myocardial infarction from 2010 to 2017: a Danish cohort study

Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan – Results From the Japanese Circulation Society Cardiovascular Shock Registry –

Predictors Of Mortality In Patients With ST-Segment Elevation Acute Myocardial Infarction And Resuscitated Out-Of-Hospital Cardiac Arrest

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Characteristics and Predictors of Mortality in Patients With Cardiovascular Shock in Japan　– Results From the Japanese Circulation Society Cardiovascular Shock Registry –