PMID- 24763491
OWN - NLM
STAT- MEDLINE
DCOM- 20140818
LR  - 20220129
IS  - 1468-201X (Electronic)
IS  - 1355-6037 (Linking)
VI  - 100
IP  - 14
DP  - 2014 Jul
TI  - Resuscitated cardiac arrest and prognosis following myocardial infarction.
PG  - 1125-32
LID - 10.1136/heartjnl-2014-305696 [doi]
AB  - OBJECTIVES: To determine whether resuscitated cardiac arrest (CA) complicating ST 
      elevation myocardial infarction (STEMI) impacts outcome, particularly in patients 
      surviving to discharge. BACKGROUND: Resuscitated CA complicating STEMI is 
      associated with increased inpatient mortality. The impact on later prognosis is 
      unclear. METHODS: We analysed data from the UK Myocardial Ischaemia National 
      Audit Project for STEMI patients admitted during January 2008-March 2010. We used 
      survival analyses to assess the independent impact of resuscitated CA during the 
      index episode on inhospital, 30 days, 1 year and medium term all-cause mortality. 
      RESULTS: Of 48 749 STEMI patients, 5308 (10.9%) were recorded as having a CA. Of 
      these, 1557 (29.3%) died on the day of CA. In survivors, after covariate 
      adjustment, resuscitated CA was associated with increased risk of death during 
      the index admission (HR 4.05 (3.69 to 4.45) p<0.001). In patients surviving to 
      discharge, a history of resuscitated CA was associated with increased risk of 
      death to 30 days (HR 1.53 (1.18 to 2.00), p<0.001). However, beyond 30 days, 
      resuscitated CA was not associated with increased mortality risk (1-year HR 0.95 
      (0.79 to 1.14, p=0.596); 3.5 years HR 0.90 (0.78 to 1.04), p=0.144). The 
      influence of resuscitated CA on inhospital or 30-day mortality was similar 
      whether CA occurred before or after hospital admission. Where the resuscitated CA 
      rhythm was asystole, inhospital mortality was higher compared with ventricular 
      arrhythmia (p<0.001) or pulseless electrical activity (p=0.011). Late 
      resuscitated CA (occurring after the day of index STEMI) was associated with 
      higher 30-day postdischarge mortality compared with early resuscitated CA 
      (p=0.023). CONCLUSIONS: STEMI complicated by resuscitated CA merits careful 
      monitoring in the early period postevent. In contemporary practice, there is no 
      impact of resuscitated CA on longer-term prognosis.
CI  - Published by the BMJ Publishing Group Limited. For permission to use (where not 
      already granted under a licence) please go to 
      http://group.bmj.com/group/rights-licensing/permissions.
FAU - Alahmar, Albert E
AU  - Alahmar AE
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Nelson, Christopher P
AU  - Nelson CP
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Snell, Kym I E
AU  - Snell KI
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Yuyun, Matthew F
AU  - Yuyun MF
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Musameh, Muntaser D
AU  - Musameh MD
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Timmis, Adam
AU  - Timmis A
AD  - Barts and The London NIHR Cardiovascular Biomedical Research Unit, Barts Health 
      NHS Trust, London, UK.
FAU - Birkhead, John S
AU  - Birkhead JS
AD  - National Institute for Cardiovascular Outcomes Research, Centre for 
      Cardiovascular Preventions and Outcomes, University College London, Leicester, 
      UK.
FAU - Chugh, Sumeet S
AU  - Chugh SS
AD  - The Heart Institute, Cedars-Sinai Medical Center, Los Angeles, California, USA.
FAU - Thompson, John R
AU  - Thompson JR
AD  - Department of Health Sciences, University of Leicester, University Road, 
      Leicester, UK.
FAU - Squire, Iain B
AU  - Squire IB
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
FAU - Samani, Nilesh J
AU  - Samani NJ
AD  - Department of Cardiovascular Sciences, University of Leicester, and Leicester 
      NIHR Cardiovascular Biomedical Research Unit, Glenfield Hospital, Leicester, UK.
LA  - eng
GR  - MC_PC_13041/MRC_/Medical Research Council/United Kingdom
GR  - MR/K006584/1/MRC_/Medical Research Council/United Kingdom
GR  - NF-SI-0611-10170/DH_/Department of Health/United Kingdom
PT  - Comparative Study
PT  - Journal Article
PT  - Multicenter Study
PT  - Research Support, Non-U.S. Gov't
DEP - 20140424
PL  - England
TA  - Heart
JT  - Heart (British Cardiac Society)
JID - 9602087
SB  - IM
CIN - Heart. 2014 Jul;100(14):1069-70. PMID: 24829370
MH  - Aged
MH  - *Cardiopulmonary Resuscitation/methods
MH  - England
MH  - Female
MH  - Follow-Up Studies
MH  - Heart Arrest/mortality/*therapy
MH  - Hospital Mortality
MH  - Humans
MH  - Male
MH  - Medical Audit
MH  - Middle Aged
MH  - Myocardial Infarction/mortality/physiopathology/*therapy
MH  - Prognosis
MH  - Risk Factors
MH  - Survival Analysis
MH  - Ventricular Fibrillation/therapy
MH  - Wales
OTO - NOTNLM
OT  - ARRHYTHMIAS
EDAT- 2014/04/26 06:00
MHDA- 2014/08/19 06:00
CRDT- 2014/04/26 06:00
PHST- 2014/04/26 06:00 [entrez]
PHST- 2014/04/26 06:00 [pubmed]
PHST- 2014/08/19 06:00 [medline]
AID - heartjnl-2014-305696 [pii]
AID - 10.1136/heartjnl-2014-305696 [doi]
PST - ppublish
SO  - Heart. 2014 Jul;100(14):1125-32. doi: 10.1136/heartjnl-2014-305696. Epub 2014 Apr 
      24.