PMID- 28728743
OWN - NLM
STAT- MEDLINE
DCOM- 20170901
LR  - 20170901
IS  - 1879-1913 (Electronic)
IS  - 0002-9149 (Linking)
VI  - 120
IP  - 5
DP  - 2017 Sep 1
TI  - Outcomes of ST Elevation Myocardial Infarction Complicated by Out-of-Hospital 
      Cardiac Arrest (from the Los Angeles County Regional System).
PG  - 729-733
LID - S0002-9149(17)30968-2 [pii]
LID - 10.1016/j.amjcard.2017.06.010 [doi]
AB  - The objective of this study was to evaluate the time to primary percutaneous 
      coronary intervention (PCI) and the outcome for patients with ST elevation 
      myocardial infarction (STEMI) complicated by out-of-hospital cardiac arrest 
      (OHCA). In this regional system, all patients with STEMI and/or OHCA with return 
      of spontaneous circulation were transported to STEMI Receiving Centers. The 
      outcomes registry was queried for patients with STEMI with underwent primary PCI 
      from April 2011 to December 2014. Patients with STEMI complicated by OHCA were 
      compared with a reference group of STEMI without OHCA. The primary end point was 
      the first medical contact-to-device time. Of 4,729 patients with STEMI who 
      underwent primary PCI, 422 patients (9%) suffered OHCA. Patients with OHCA were 
      on average 2 years (95% confidence interval 0.7 to 3.0) older and had a slightly 
      higher male predominance. The first medical contact-to-device time was longer in 
      STEMI with OHCA compared with STEMI alone (94 +/- 37 vs. 86 +/- 34 minutes, 
      p < 0.0001). In-hospital mortality was higher after OHCA, 38% versus 6% in STEMI 
      alone, odds ratio 6.3 (95% confidence interval 5.3 to 7.4). Among OHCA survivors, 
      193 (73%) were discharged with a cerebral performance category score of 1 or 2. 
      In conclusion, despite longer treatment intervals, neurologic outcome was good in 
      nearly half of the surviving patients with STEMI complicated by OHCA, suggesting 
      that these patients can be effectively treated with primary PCI in a regionalized 
      system of care.
CI  - Copyright (c) 2017 Elsevier Inc. All rights reserved.
FAU - Shavelle, David M
AU  - Shavelle DM
AD  - Division of Cardiovascular Medicine, University of Southern California, Los 
      Angeles, California. Electronic address: shavelle@usc.edu.
FAU - Bosson, Nichole
AU  - Bosson N
AD  - Los Angeles County Emergency Medical Services Agency, Santa Fe Springs, 
      California; Department of Emergency Medicine, Harbor-UCLA Medical Centre and the 
      Los Angeles Biomedical Institute, Torrance, California; David Geffen School of 
      Medicine, University of California Los Angeles, Los Angeles, California.
FAU - Thomas, Joseph L
AU  - Thomas JL
AD  - David Geffen School of Medicine, University of California Los Angeles, Los 
      Angeles, California; Division of Cardiology, Harbor-UCLA Medical Centre and the 
      Los Angeles Biomedical Institute, Torrance, California.
FAU - Kaji, Amy H
AU  - Kaji AH
AD  - Department of Emergency Medicine, Harbor-UCLA Medical Centre and the Los Angeles 
      Biomedical Institute, Torrance, California; David Geffen School of Medicine, 
      University of California Los Angeles, Los Angeles, California.
FAU - Sung, Gene
AU  - Sung G
AD  - Department of Neurology, University of Southern California, Los Angeles, 
      California.
FAU - French, William J
AU  - French WJ
AD  - David Geffen School of Medicine, University of California Los Angeles, Los 
      Angeles, California; Division of Cardiology, Harbor-UCLA Medical Centre and the 
      Los Angeles Biomedical Institute, Torrance, California.
FAU - Niemann, James T
AU  - Niemann JT
AD  - Department of Emergency Medicine, Harbor-UCLA Medical Centre and the Los Angeles 
      Biomedical Institute, Torrance, California; David Geffen School of Medicine, 
      University of California Los Angeles, Los Angeles, California.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
DEP - 20170615
PL  - United States
TA  - Am J Cardiol
JT  - The American journal of cardiology
JID - 0207277
SB  - IM
MH  - Cardiopulmonary Resuscitation
MH  - Female
MH  - Follow-Up Studies
MH  - Hospital Mortality/trends
MH  - Humans
MH  - Incidence
MH  - Los Angeles/epidemiology
MH  - Male
MH  - Middle Aged
MH  - Out-of-Hospital Cardiac Arrest/epidemiology/*etiology/therapy
MH  - *Percutaneous Coronary Intervention
MH  - Prognosis
MH  - Retrospective Studies
MH  - ST Elevation Myocardial Infarction/*complications/mortality/surgery
MH  - Survival Rate/trends
EDAT- 2017/07/22 06:00
MHDA- 2017/09/02 06:00
CRDT- 2017/07/22 06:00
PHST- 2017/03/27 00:00 [received]
PHST- 2017/05/16 00:00 [revised]
PHST- 2017/06/01 00:00 [accepted]
PHST- 2017/07/22 06:00 [pubmed]
PHST- 2017/09/02 06:00 [medline]
PHST- 2017/07/22 06:00 [entrez]
AID - S0002-9149(17)30968-2 [pii]
AID - 10.1016/j.amjcard.2017.06.010 [doi]
PST - ppublish
SO  - Am J Cardiol. 2017 Sep 1;120(5):729-733. doi: 10.1016/j.amjcard.2017.06.010. Epub 
      2017 Jun 15.