Prognostic significance of shockable and non-shockable cardiac arrest in ST-segment elevation myocardial infarction patients undergoing primary angioplasty

• Published in: Resuscitation 2018-02, Vol.123, p.8-14
• Main Authors: Taglieri, Nevio, Saia, Francesco, Bacchi Reggiani, Maria Letizia, Ghetti, Gabriele, Bruno, Antonio Giulio, Rosetti, Claudia, Bruno, Matteo, Corsini, Anna, Battistini, Paola, Lanati, Gianluca, Di Dio, Maria Teresa, Della Riva, Diego, Compagnone, Miriam, Marrozzini, Cinzia, Rapezzi, Claudio
• Format: Article
• Language: English
• Subjects: Cardiac arrest; Outcome; STEMI
• ISSN: 0300-9572; 1873-1570
• DOI: 10.1016/j.resuscitation.2017.12.006

To determine, in patients with ST-segment Elevation Myocardial Infarction (STEMI) undergoing primary percutaneous coronary intervention (PPCI), the prognostic weight of cardiac arrest (CA) according to the type of rhythm (shockable vs. non-shockable). We prospectively enrolled 3278 consecutive STEMI patients undergoing PPCI. Multivariable Cox regression was used to establish the relation to 1-year cardiac mortality of both type of CA. In patients suffering from CA we identified predictors of both poor neurological outcome (cerebral performance categories 3–5) and cardiac mortality at 1year. The incidence of CA was 7.26% (n=238). Of these, 196 (5.98%) had an initial shockable rhythm and 42 (1.28%) a non shockable rhythm. During 1-year follow up 311(9.48%) patients died from cardiac causes. Shockable rhythm (adjusted-HR=1.61; 95%CI 1.08–2.43, p=0.02) and non-shockable rhythm (adjusted-HR=3.83; 95%CI 2.36–6.22, p