Author + information
- Claire Donovan,
- Benjamin Johnson,
- Ross Garberich,
- John Hibbs,
- David Larson,
- Timothy Henry and
- Scott Sharkey
Background: The influence of cardiac arrest and cardiogenic shock on outcomes of patients with ST-elevation myocardial infarction (STEMI) in the percutaneous coronary intervention (PCI) era is incompletely studied.
Methods: We examined a regional STEMI network to determine incidence, characteristics and outcomes of STEMI complicated by cardiac arrest with and without cardiogenic shock. Cardiac arrest was classified as shockable (ventricular tachycardia/ventricular fibrillation) or non-shockable (asystole/pulseless electrical activity).
Results: From March 2003 – December 2014, we enrolled 4,511 consecutive patients including 499 (11%) with cardiac arrest prior to PCI. The cardiac arrest was shockable in 441 (88%) patients and non-shockable in 58 (12%) patients.
Conclusions: In this contemporary STEMI population, most with cardiac arrest had no history of myocardial infarction or revascularization. Cardiogenic shock influenced hospital mortality only in those with shockable rhythm. A non-proximal coronary culprit was present in one-third of patients with shockable and non-shockable cardiac arrest and culprit coronary anatomy was no different in those with and without cardiogenic shock. Nearly 75% of patients with shockable arrest survived to discharge, 95% of whom were alive at 1 year. In contrast, only 40% of patients with non-shockable arrest survived to discharge, 92% of whom were alive at 1 year.
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: 1204-346
- 2017 American College of Cardiology Foundation