Document Detail


Six-month outcome of emergency percutaneous coronary intervention in resuscitated patients after cardiac arrest complicating ST-elevation myocardial infarction.
MedLine Citation:
PMID:  17353440     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: The outcome of resuscitated patients after cardiac arrest complicating acute myocardial infarction remains poor, primarily because of the relatively low success rates of cardiopulmonary resuscitation management. Existing data suggest potential beneficial effects of early myocardial reperfusion, but the predictors of survival in these patients remain unknown. METHODS AND RESULTS: From 1995 to 2005, 186 patients (78% men; mean age, 60.4+/-13.8 years) underwent immediate percutaneous coronary intervention after successful resuscitation for cardiac arrest complicating acute myocardial infarction. Prompt prehospital management was performed by mobile medical care units in 154 of 186 patients, whereas 32 had in-hospital cardiac arrest. Infarct location was anterior in 105 patients (56%), and shock was present on admission in 96 (52%). Percutaneous coronary intervention (stenting rate 90%) was successful in 161 of 186 patients (87%). Six-month survival rate was 100 of 186 (54%), and 6-month survival free of neurological sequelae was 46%. By multivariate analysis, predictors of 6-month survival were a shorter interval between the onset of cardiac arrest and arrival of a first responder (odds ratio, 0.67; 95% CI, 0.54 to 0.84), a shorter interval between the onset of cardiac arrest and return of spontaneous circulation (odds ratio, 0.91; 95% CI, 0.87 to 0.96), and absence of diabetes (odds ratio, 7.30; 95% CI, 1.80 to 29.41). CONCLUSIONS: In patients with resuscitated cardiac arrest complicating acute myocardial infarction, prompt prehospital management and early revascularization were associated with a 54% survival rate at 6 months. A strategy including adequate prehospital management, early revascularization, and specific care in dedicated intensive care units should be strongly considered in resuscitated patients after cardiac arrest complicating acute myocardial infarction.
Authors:
Philippe Garot; Thierry Lefevre; Hélène Eltchaninoff; Marie-Claude Morice; Fabienne Tamion; Bernard Abry; Pierre-François Lesault; Jean-Yves Le Tarnec; Claude Pouges; Alain Margenet; Mehran Monchi; Ivan Laurent; Pierre Dumas; Jérôme Garot; Yves Louvard
Publication Detail:
Type:  Journal Article     Date:  2007-03-12
Journal Detail:
Title:  Circulation     Volume:  115     ISSN:  1524-4539     ISO Abbreviation:  Circulation     Publication Date:  2007 Mar 
Date Detail:
Created Date:  2007-03-20     Completed Date:  2007-04-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1354-62     Citation Subset:  AIM; IM    
Affiliation:
Institut Cardiovasculaire Paris-Sud, Centre Hospitalier Claude Galien, 20 Route de Boussy, 91480 Quincy, France. p.garot@icps.com.fr
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MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary / mortality*,  statistics & numerical data
Cardiopulmonary Resuscitation / mortality*,  statistics & numerical data
Electrocardiography
Emergency Medical Services / methods,  statistics & numerical data*
Female
Follow-Up Studies
Heart Arrest / mortality*,  therapy
Heart Catheterization / mortality,  statistics & numerical data
Hospital Mortality
Humans
Intensive Care / statistics & numerical data
Male
Middle Aged
Myocardial Infarction / diagnosis,  mortality*,  therapy
Predictive Value of Tests
Retrospective Studies
Survival Rate
Treatment Outcome

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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