Key result
ST-elevation myocardial infarction was a strong independent predictor of out-of-hospital cardiac arrest in young adults hospitalized with acute coronary syndrome (OR 5.862).
Why the study?
The characteristics of young adults with out-of-hospital cardiac arrest due to ACS had not been well described.
Cohort (n=31,620)
Yes
In young adults presenting with acute coronary syndrome, out-of-hospital cardiac arrest is frequently the sentinel event of coronary artery disease and is strongly predicted by male sex, STEMI presentation, and non-smoking status.
Answers are grounded in this paper and cite their sources.
STEMI, male sex, and non-smoking may signal higher OHCA risk in young ACS patients; leaves open need for prospective validation and prevention trials.
INTRODUCTION: The characteristics of young adults with out-of-hospital cardiac arrest (OHCA) due to acute coronary syndrome (ACS) has not been well described. The mean age of gulf citizens in ACS registries is 10-15 years younger than their western counterparts, which provided us with a unique opportunity to investigate the characteristics and predictors of OHCA in young adults presenting with ACS. METHODOLOGY: This was a retrospective cohort study using data from 7 prospective ACS registries in the Gulf region. In brief, all registries included consecutive adults who were admitted with ACS. OHCA was defined as cardiac arrest upon presentation (i.e., before admission to the hospital). We described the characteristics of young adults (< 50 years) who had OHCA and performed multivariate logistic regression analysis to assess independent predictors of OHCA. RESULTS: A total of 31,620 ACS patients were included in the study. There were 611 (1.93%) OHCA cases in the whole cohort [188/10,848 (1.73%) in young adults vs 423/20,772 (2.04%) in older adults, p = 0.06]. Young adults were predominantly males presenting with ST-elevation myocardial infarction (STEMI) [182/188 (96.8%) and 172/188 (91.49%), respectively]. OHCA was the sentinel event of coronary artery disease (CAD) in 70% of young adults. STEMI, male sex, and non-smoking status were found to be independent predictors of OHCA [OR = 5.862 (95% CI 2.623-13.096), OR: 4.515 (95% CI 1.085-18.786), and OR = 2.27 (95% CI 1.335-3.86), respectively]. CONCLUSION: We observed a lower prevalence of OHCA in ACS patients in our region as compared to previous literature from other regions. Moreover, OHCA was the sentinel event of CAD in the majority of young adults, who were predominantly males with STEMIs. These findings should help risk-stratify patients with ACS and inform further research into the characteristics of OHCA in young adults.
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Alsaeed et al. (2023) conducted a cohort in Acute coronary syndrome (n=31,620). ST-elevation myocardial infarction (STEMI) vs. Non-STEMI was evaluated on Out-of-hospital cardiac arrest (OHCA) (OR 5.862, 95% CI 2.623-13.096, p=<0.001). ST-elevation myocardial infarction was a strong independent predictor of out-of-hospital cardiac arrest in young adults hospitalized with acute coronary syndrome (OR 5.862).
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