Author + information
- Kinga Kozma,
- Csaba Kun and
- Zoltan Csanadi
Background: Acute coronary syndromes (ACS) present with out of hospital cardiac arrest (OHCA) in 3-4% of cases. The aim of this study was to identify predictors of short-term (in-hospital) and long-term (post-discharge) mortality in those patients who survived to hospital admission after an ACS and OHCA.
Methods: Data related to successful resuscitation and to acute hospital care were retrospectively analyzed in patients admitted to our Institute for an ACS which presented as an OHCA between 2008-2015. All patients underwent early percutaneous coronary intervention (PCI) and targeted temperature management. Predictive values of different variables were determined with logistic regression using in-hospital death as the end-point for short-term and death of any cause after hospital discharge as the end-point for long-term survival.
Results: Out of 104 patients (82 man, age: 58,03±10,94) admitted for ACS and OHCA, 64 (62%) survived to hospital discharge. Significant predictors of in-hospital mortality included (odds ratio): first measured pH<7,1 (5,56); renal failure (33,85); diagnosis of nSTEMl (2,95), a non-shockable rhythm at first detection (4,06) and resuscitation not started by a lay bystander (3,79). Out of the 64 patients who were discharged from hospital, 29 (45%) died during a mean follow-up of 48,21 ±24,45 months, 15 patients (37,5%) died out of those 40 who were transported to our Institute immediately after OHCA, while 14 patients (58,3%) died out 24, who were transported first to an other facility with no access to an early PCI (OR: 2,27). None of the other variables was found to be a signifiant prognosticator for long-term mortality.
Conclusions: In-hospital mortality is mostly predicted by variables related to resuscitation in ACS presenting as OHCA. First care in a PCI center after the acute event is asscosiated with long-term mortality benefit.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Novel Developments in Acute Coronary Syndromes
Abstract Category: 15. Interventional Cardiology: ACS/AMI/Hemodynamics and Pharmacology
Presentation Number: 1194-146
- 2017 American College of Cardiology Foundation