Key result
PCI linked to ~94% lower in-hospital mortality in AMI complicated by cardiac arrest.
Why the study?
The prognosis and potential for neurologically intact survival after prolonged ventricular fibrillation cardiac arrest treated with mechanical CPR and intra-arrest PCI remain unclear.
Cohort (n=66)
No
Odds Ratio: 0.063 (95% CI 0.012–0.318)
Absolute Event Rate: 9.5% vs 68.9%
p-value: p=0.001
May support intra-arrest PCI during mechanical CPR in select prolonged arrests; leaves open mortality benefit in broader AMI cardiac arrest populations.
We report a case of a 56 year old male in ventricular fibrillation (VF) cardiac arrest for a total of 2 hours and 50 minutes who was diagnosed with ST elevation myocardial infarction (STEMI) during a brief 10 min period of return of spontaneous circulation (ROSC). The patient underwent successful percutaneous coronary intervention (PCI) while receiving mechanical chest compressions for ongoing VF. Our case demonstrates the potential for neurologically intact survival in VF cardiac arrest patients despite prolonged periods of VF who are treated with mechanical CPR and intra-arrest PCI.
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Burnett et al. (2018) conducted a cohort in Cardiac arrest caused by acute myocardial infarction (n=66). Percutaneous coronary intervention (PCI) vs. No PCI was evaluated on In-hospital mortality (OR 0.063, 95% CI 0.012-0.318, p=0.001). Percutaneous coronary intervention was associated with a significantly lower risk of in-hospital mortality compared to no intervention (OR 0.063) in patients with acute myocardial infarction complicated by cardiac arrest.
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