Clinical and angiographic characteristics of out-of-hospital cardiac arrest among patients with ST-segment elevation myocardial infarction - 17/02/24
, Benjamin Munnich a, 2, Pierre Brami a, b, 2, Ruxandra Sava a, Vincent Pham a, Alain Cariou b, c, Olivier Varenne a, bGraphical abstract |
Highlights |
• | Clinical/angiographic OHCA predictors in patients with STEMI not studied widely. |
• | We included 686 patients with STEMI, including 148 with concomitant OHCA. |
• | We assessed baseline clinical, angiographic and biological characteristics. |
• | Culprit lesion localized on the left system was associated with OHCA. |
• | Culprit lesion at the level of a bifurcation lesion was associated with OHCA. |
• | Chronic total occlusion on a non-culprit artery was associated with OHCA. |
Abstract |
Background |
Out-of-hospital cardiac arrest (OHCA) is the most severe complication of ST-segment elevation myocardial infarction (STEMI). Nevertheless, clinical and angiographic characteristics associated with OHCA among patients with STEMI have not been studied extensively.
Aim |
To evaluate the clinical and angiographic characteristics of consecutive patients who presented with STEMI associated or not with OHCA.
Methods |
This was an observational study including consecutive patients treated for STEMI associated or not with OHCA. Baseline clinical and angiographic characteristics, biological characteristics and mortality were compared between patients with STEMI who experienced OHCA and patients with STEMI who did not.
Results |
Among the 686 included patients with STEMI, 148 (21.6%) presented with concomitant OHCA. Multivariable analysis revealed that culprit lesion localized on the left system (odds ratio [OR] 1.94, 95% confidence interval [CI] 1.24–3.13; P<0.01), culprit lesion at the level of a bifurcation lesion (OR 1.87, 95% CI 1.21–2.88; P<0.01) and the presence of chronic total occlusion on another artery (OR 3.39, 95% CI 1.93–5.99; P<0.001) were associated with the occurrence of OHCA, whereas dyslipidaemia, familial history of coronary artery disease and hypertension were found to be negatively associated with the occurrence of OHCA in patients with STEMI: OR 0.47, 95% CI 0.29–0.75 (P<0.01); OR 0.09, 95% CI 0.02–0.25 (P<0.001); and OR 0.60, 95% CI 0.38–0.93 (P=0.02), respectively.
Conclusion |
In this study of consecutive patients with STEMI, culprit lesion localized on the left system, culprit lesion at the level of a bifurcation lesion and the presence of chronic total occlusion on a non-culprit artery were associated with OHCA.
Le texte complet de cet article est disponible en PDF.Keywords : Cardiac arrest, Acute coronary syndrome, Chronic total occlusion
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Vol 117 - N° 2
P. 153-159 - février 2024 Retour au numéro
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