Aortic stenosis is associated with a 42% lower probability of 30-day survival following out-of-hospital cardiac arrest compared to patients without valvular heart disease (OR 0.58).
Observational (n=55,615)
Sí
Does pre-existing left-sided valvular heart disease affect survival and neurological outcomes in patients experiencing out-of-hospital cardiac arrest?
Pre-existing aortic stenosis nearly halves the chance of 30-day survival following out-of-hospital cardiac arrest, whereas aortic and mitral regurgitation do not significantly impact survival.
Estimación del efecto: OR 0.58 (95% CI 0.46-0.72)
Tasa de eventos absoluta: 5.2% vs 11.4%
Survival in left-sided valvular heart disease (VHD; aortic stenosis AS, aortic regurgitation AR, mitral stenosis MS, mitral regurgitation MR) in out-of-hospital cardiac arrest (OHCA) is unknown. We studied all cases of OHCA in the Swedish Registry for Cardiopulmonary Resuscitation. All degrees of VHD, diagnosed prior to OHCA, were included. Association between VHD and survival was studied using logistic regression, gradient boosting and Cox regression. We studied time to cardiac arrest, comorbidities, survival, and cerebral performance category (CPC) score. We included 55,615 patients; 1948 with AS (3,5%), 384 AR (0,7%), 17 MS (0,03%), and 704 with MR (1,3%). Patients with MS were not described due to low case number. Time from VHD diagnosis to cardiac arrest was 3.7 years in AS, 4.5 years in AR and 4.1 years in MR. ROSC occurred in 28% with AS, 33% with AR, 36% with MR and 35% without VHD. Survival at 30 days was 5.2%, 10.4%, 9.2%, 11.4% in AS, AR, MR and without VHD, respectively. There were no survivors in people with AS presenting with asystole or PEA. CPC scores did not differ in those with VHD compared with no VHD. Odds ratio (OR) for MR and AR showed no difference in survival, while AS displayed OR 0.58 (95% CI 0.46-0.72), vs no VHD. AS is associated with halved survival in OHCA, while AR and MR do not affect survival. Survivors with AS have neurological outcomes comparable to patients without VHD.
Dejby et al. (Fri,) conducted a observational in Out-of-hospital cardiac arrest (n=55,615). Aortic stenosis vs. No valvular heart disease was evaluated on Survival at 30 days (OR 0.58, 95% CI 0.46-0.72). Aortic stenosis is associated with a 42% lower probability of 30-day survival following out-of-hospital cardiac arrest compared to patients without valvular heart disease (OR 0.58).