Author + information
- Christopher Fordycea,b,
- Anita Chena,b,
- Tracy Wanga,b,
- Joseph Lucasa,b,
- Abhinav Goyala,b,
- Graham Wonga,b,
- Sean Van Diepena,b,
- Michael Kontosa,b,
- Timothy Henrya,b,
- Christopher Grangera,b and
- Matthew Roea,b
Background: Contemporary treatment patterns and characteristics of patients receiving targeted temperature management (TTM) for acute myocardial infarction (MI) complicated by out-of-hospital cardiac arrest (OHCA) in the U.S. have not been characterized.
Methods: We studied 5260 patients with acute MI (75% with STEMI) complicated by OHCA from 01/2015 to 03/2016 at 691 hospitals in ACTION Registry-GWTG. Patient and hospital factors associated with TTM were evaluated using logistic regression. To assess hospital variation in TTM, we examined a subset of 2654 patients at 155 hospitals that treated ≥ 10 OHCA patients and categorized hospitals by % OHCA patients receiving TTM.
Results: Overall, 34.1% of MI patients with OHCA were treated with TTM. Patient factors strongly associated with TTM use in the multivariable model included the presence of shock, higher initial creatinine and heart rate, lower blood pressure and younger age (Table). TTM use rates varied widely across hospitals from 0% to 82% of MI patients with OHCA; median 33%. Patient and hospital characteristics were similar across hospital tertiles with low (mean TTM use = 15.2%), intermediate (34.0%), and high (56.3%) rates of TTM use.
Conclusions: In this first nationwide evaluation of TTM for MI patients with OHCA, we observed wide variability across U.S. hospitals in TTM use and delineated factors associated with TTM. These results may guide quality improvement efforts to increase appropriate TTM use among MI patients with OHCA.
Poster Hall, Hall C
Saturday, March 18, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Cardiac Arrest, Diabetes, and Other High Risk Features of Patients With Acute Coronary Syndrome
Abstract Category: 2. Acute and Stable Ischemic Heart Disease: Clinical
Presentation Number: 1204-317
- 2017 American College of Cardiology Foundation