Incidence and Predictors of Out-of-Hospital Cardiac Arrest Within 90 Days After Myocardial Infarction

• Published in: Journal of the American College of Cardiology 2020-12, Vol.76 (25), p.2926-2936
• Main Authors: Faxén, Jonas, Jernberg, Tomas, Hollenberg, Jacob, Gadler, Fredrik, Herlitz, Johan, Szummer, Karolina
• Format: Article
• Language: English
• Subjects: Aged; Atrial Fibrillation - diagnosis; Atrial Fibrillation - epidemiology; Atrial Fibrillation - etiology; cardiac arrest; Coronary Angiography - methods; Coronary Angiography - statistics & numerical data; Diabetes Mellitus - diagnosis; Diabetes Mellitus - epidemiology; epidemiology; Female; Glomerular Filtration Rate; Humans; Incidence; Male; Medicin och hälsovetenskap; myocardial infarction; Myocardial Infarction - complications; Myocardial Infarction - therapy; Människan i vården; Out-of-Hospital Cardiac Arrest - diagnosis; Out-of-Hospital Cardiac Arrest - epidemiology; Patient Discharge - statistics & numerical data; predictors; Prognosis; Registries - statistics & numerical data; Risk Assessment - methods; Risk Factors; Sex Factors; Stroke Volume; sudden cardiac death; Sweden - epidemiology; The Human Perspective in Care; Ventricular Dysfunction, Left - diagnosis; Ventricular Dysfunction, Left - epidemiology; Ventricular Dysfunction, Left - etiology
• ISSN: 0735-1097; 1558-3597; 1558-3597
• DOI: 10.1016/j.jacc.2020.10.033

The risk of sudden cardiac death (SCD) is high early after myocardial infarction (MI). Current knowledge and guidelines mainly rely on results from older clinical trials and registry studies. Left ventricular ejection fraction (LVEF) alone has not been proven a reliable predictor of SCD. This study sought to identify the incidence and additional predictors of SCD early after MI in a contemporary nationwide setting. The authors used data from SWEDEHEART, the Swedish Cardiopulmonary Resuscitation Registry, and the Swedish Pacemaker and Implantable Cardioverter-Defibrillator (ICD) Registry. Cases of MI, which had undergone coronary angiography and were discharged alive between 2009 to 2017 without a prior ICD, were followed up to 90 days. Cox regression models were used to assess associations between clinical parameters and out-of-hospital cardiac arrest (OHCA). Among 121,379 cases, OHCA occurred in 349 (0.29%) and non-OHCA death in 2,194 (1.8%). A total of 6 variables (male sex, diabetes, estimated glomerular filtration rate