Survival after Resuscitated Out-of-Hospital Cardiac Arrest in Patients with Paramedic-Identified ST-Segment Elevation Myocardial Infarction Treated with Primary Percutaneous Coronary Intervention

• Published in: Prehospital emergency care 2022-11, Vol.26 (6), p.764-771
• Main Authors: Doan, Tan N., Prior, Marcus, Vollbon, William, Rogers, Brett, Rashford, Stephen, Bosley, Emma
• Format: Article
• Language: English
• Subjects: out-of-hospital cardiac arrest; paramedics; percutaneous coronary intervention; prehospital; ST-segment elevation myocardial infarction
• ISSN: 1090-3127; 1545-0066
• DOI: 10.1080/10903127.2021.1992054

Background: ST-segment elevation myocardial infarction (STEMI) is a common cause of out-of-hospital cardiac arrest (OHCA). For these patients, urgent angiography and revascularization is an important treatment goal. There is a lack of data on the prognosis of STEMI patients after OHCA, who are diagnosed and treated by paramedics prior to hospital transport for primary percutaneous coronary intervention (PCI). Methods: Included were adult STEMI patients identified and treated by paramedics in Queensland (Australia) from January 2016 to December 2019, transported to a hospital for primary PCI, and receiving primary PCI. Patients were grouped into those with resuscitated OHCA and those without OHCA. Clinically-important time intervals, angiographic and clinical profiles, and survival were described. Results: Patients with OHCA had longer time intervals from prehospital STEMI identification to reperfusion than those without OHCA (median 97 versus 87 mins, p = 0.001). The former had higher rates of cardiac arrhythmia history (50.5 versus 12.4%, p