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Title: Percutaneous coronary intervention outcomes following out-of-hospital cardiac arrest for patients with and without ST-elevation myocardial infarction.
Author: Dawson, L.
Dinh, D.
Duffy, S.
Brennan, A.
Clark, D.
Blusztein, D.
Stub, D.
Andrianopoulos, N.
Freeman, M.
Oqueli, Ernesto
Hutchison, A.
Ajani, A.
Issue Date: 2019
Conference Name: 67th Cardiac Society of Australia and New Zealand Annual Scientific Meeting, the International Society for Heart Research Australasian Section Annual Scientific Meeting and the 13th Annual Australia and New Zealand Endovascular Therapies Meeting.
Conference Date: August 8th-11th
Conference Place: Adelaide, Australia
Abstract: Background: Outcomes after out-of-hospital cardiac arrest (OHCA) remain poor, and percutaneous coronary intervention (PCI) may have prognostic benefit in patients with a culprit coronary lesion. We aimed to describe outcomes among patients undergoing PCI following OHCA and the effect of ST-elevation myocardial infarction on outcome. Methods: Data were prospectively collected on 1,047 consecutive PCI procedures following OHCA at six Victorian public hospitals from 2005 to 2017. Patients were divided into those with STEMI (OHCA-S) and those without (OHCA-NS). Outcomes were compared against patients with STEMI only without OHCA ( n = 9,694). Results: OHCA-S patients were younger and the treated lesion was more commonly occluded at time of PCI (63% vs 22%, p < 0.001). GP-IIb/IIIa antagonists, thrombus aspiration and intra-aortic balloon pump insertion were more frequently used for OHCA-S ( p < 0.01). Cardiogenic shock (CS) was present in 47% of OHCA-S and 29% of OHCA-NS ( p < 0.001). 30-day mortality was 34% for the OHCA-S and 18% for the OHCA-NS group. However, OHCA-S and OHCA-NS had similar long-term outcomes to the STEMI only group if they survived to 30-days. Multivariable predictors for 30-day mortality after PCI for OHCA were diabetes, impaired renal or LV function, and CS. Conclusions: PCI following OHCA has a high 30-day mortality, with worse outcomes among patients with STEMI. Beyond 30-days, long-term outcomes are similar to uncomplicated STEMI cohorts.
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Internal ID Number: 01376
Type: Conference
Appears in Collections:Research Output

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