Key result
Out-of-hospital cardiac arrest predicts ~24-fold higher risk of SCA within 48 hours post-STEMI PCI.
Why the study?
Data on the incidence, predictors, and outcomes of sudden cardiac arrest in the immediate post-PCI period for STEMI are limited.
Cohort (n=403)
No
Odds Ratio: 23.9 (95% CI 10.2–56.1)
Out-of-hospital cardiac arrest, left main disease/intervention, new-onset heart failure, and cardiogenic shock are significant predictors of sudden cardiac arrest within 48 hours after PCI for STEMI.
Out-of-hospital cardiac arrest flags highest early SCA risk after STEMI PCI; hypothesis-generating for enhanced monitoring, pending validation.
BACKGROUND: Data on the incidence, predictors, and outcomes of sudden cardiac arrest (SCA) in the immediate post-percutaneous coronary intervention (PCI) period for ST-elevation myocardial infarction (STEMI) are limited. OBJECTIVES: The study aimed to investigate the trends and predictors of SCA occurring within 48 h post PCI for STEMI. METHODS: We systematically reviewed data from the electronic medical records of 403 patients who underwent PCI for STEMI between January 2014 and December 2019. Trends in the incidence of SCA 48 h post PCI for STEMI were assessed using the Cochrane-Armitage test. Multivariable logistic regression was used to determine the predictors of SCA within 48 h post PCI for STEMI. RESULTS: Of the 403 patients who underwent PCI for STEMI, 44 (11%) had SCA within 48 h post PCI. The incidence of SCA within 48 h post PCI decreased from 22% in 2014 to 8% in 2019; P = 0.03. After adjusting for underlying confounding variables in the multivariable logistic regression models, out of hospital cardiac arrest [adjusted odds ratio (aOR), 23.9; confidence interval (CI), 10.2-56.1], left main coronary artery disease (aOR, 3.1; CI, 1.1-9.4), left main PCI (aOR, 6.6; CI: 1.4-31.7), new-onset heart failure (aOR, 2.0; CI, 4.3-9.4), and cardiogenic shock (aOR, 5.8; CI, 1.7-20.2) were statistically significant predictors of SCA within 48 h post PCI for STEMI. CONCLUSION: We identified essential factors associated with SCA within 48 h post PCI for STEMI. Future studies are needed to devise effective strategies to decrease the risk of SCA in the early post-PCI period.
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A 2022 study conducted a cohort in ST-elevation myocardial infarction (STEMI) (n=403). Out of hospital cardiac arrest vs. No out of hospital cardiac arrest was evaluated on Sudden cardiac arrest within 48 h post PCI (aOR 23.9, 95% CI 10.2-56.1). Out-of-hospital cardiac arrest was the strongest predictor of sudden cardiac arrest within 48 hours post-PCI for STEMI (aOR 23.9; 95% CI 10.2-56.1), which occurred in 11% of patients overall.
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