Key result
Among patients with out-of-hospital cardiac arrest, only 30% of those admitted to the hospital were diagnosed with acute myocardial infarction, indicating it is now a minority cause.
Why the study?
Previous studies have shown conflicting results regarding the prevalence and significance of comorbidities in OHCA, as well as the underlying causes.
Observational (n=54,484)
Yes
Answers are grounded in this paper and cite their sources.
Contrary to historical data attributing 80% of sudden cardiac arrests to coronary artery disease, this nationwide Swedish registry study found that only 30% of hospitalized OHCA patients were diagnosed with acute myocardial infarction.
BACKGROUND: Out-of-hospital cardiac arrest (OHCA) has a dismal prognosis with overall survival around 10%. Previous studies have shown conflicting results regarding the prevalence and significance of comorbidities in OHCA, as well as the underlying causes. Previously, 80% of sudden cardiac arrest have been attributed to coronary artery disease. We studied comorbidities and discharge diagnoses in OHCA in all of Sweden. METHODS: We used the Swedish Registry of Cardiopulmonary Resuscitation, merged with the Inpatient Registry and Outpatient Registry to identify patients with OHCA from 2010 to 2020 and to collect all their comorbidities as well as discharge diagnoses (among those admitted to hospital). Patient characteristics were described using means, medians and SD. Survival curves were performed among hospitalised patients with acute myocardial infarction (AMI) as well as heart failure. RESULTS: A total of 54 484 patients with OHCA were included, of whom 35 894 (66%) were men. The most common comorbidities prior to OHCA were hypertension (43.6%), heart failure (23.6%), chronic ischaemic heart disease (23.6%) and atrial fibrillation (22.0%). Previous AMI was prevalent in 14.8% of men and 10.9% of women. Among women, 18.0% had type 2 diabetes, compared with 19.6% of the men. Among hospitalised patients, 30% were diagnosed with AMI, 27% with hypertension, 20% with ischaemic heart disease and 18% with heart failure as discharge diagnoses. CONCLUSION: In summary, we find evidence that nowadays a minority of cardiac arrests are due to coronary artery disease and AMIs and its complications. Only 30% of all cases of OHCA admitted to hospital were diagnosed with AMI. Coronary artery disease is now likely in the minority with regard to causes of OHCA.
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Hjärtstam et al. (2023) conducted an observational in Out-of-hospital cardiac arrest (n=54,484). Out-of-hospital cardiac arrest was evaluated on Prevalence of comorbidities prior to OHCA and discharge diagnoses. Among patients with out-of-hospital cardiac arrest, only 30% of those admitted to the hospital were diagnosed with acute myocardial infarction, indicating it is now a minority cause.
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