Kristin M Kvakkestad1, Leiv Sandvik2, Geir Øystein Andersen3, Kjetil Sunde4, Sigrun Halvorsen5. 1. Department of Cardiology, Oslo University Hospital Ulleval, Postboks 4950 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway. Electronic address: kristinturcuta@gmail.com. 2. Oslo Centre for Biostatistics and Epidemiology, Research Support Services, P.O. Box 1122 Blindern, 0317 Oslo, Norway. 3. Department of Cardiology, Oslo University Hospital Ulleval, Postboks 4950 Nydalen, 0424 Oslo, Norway. 4. Institute of Clinical Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway; Department of Anaesthesiology, Division of Emergencies and Critical Care, Oslo University Hospital Ulleval, Postboks 4950 Nydalen, 0424 Oslo, Norway. 5. Department of Cardiology, Oslo University Hospital Ulleval, Postboks 4950 Nydalen, 0424 Oslo, Norway; Institute of Clinical Medicine, University of Oslo, P.O. Box 1072 Blindern, 0316 Oslo, Norway.
Abstract
AIM: To compare short- and long-term survival in patients admitted to hospital after acute myocardial infarction (AMI) with and without out-of-hospital cardiac arrest (OHCA). METHODS: Prospective cohort study of all AMI patients admitted to Oslo University Hospital Ulleval from September 1, 2005 to December 31, 2011. All-cause mortality was obtained from the Norwegian Cause of Death Registry with censoring date December 31, 2013. Cumulative survival was assessed with the Kaplan-Meier and the Life-table method. Logistic- and Cox regression were used for risk comparisons. RESULTS: We identified 404 AMI patients with OHCA and 9425 AMI patients without. AMI patients without OHCA were categorized as ST-elevation myocardial infarction (STEMI, n=4522) or non-STEMI (NSTEMI, n=4903). Mean age was 63.6±standard deviation (SD) 12.5, 63.8±13.1 and 69.7±13.6 years in OHCA, STEMI and NSTEMI, respectively. Coronary angiography with subsequent percutaneous coronary intervention if indicated, was performed in 87% of OHCA, 97% of STEMI and 80% of NSTEMI patients. Thirty-day survival was 63%, 94% and 94%, and 8-year survival was 49%, 74%, and 57%, respectively. Among patients surviving the first 30days, no significant difference in risk during long-term follow-up was found (adjusted Hazard Ratio (aHR)OHCAvsSTEMI 1.15 [95% CI 0.82-1.60], aHROHCAvsNSTEMI 0.89 [95% CI 0.64-1.24]). CONCLUSIONS: Long-term survival after OHCA due to AMI was good, with 49% of admitted patients being alive after eight years. Although short-term mortality remained high, OHCA patients alive after 30days had similar long-term risk as AMI patients without OHCA.
AIM: To compare short- and long-term survival in patients admitted to hospital after acute myocardial infarction (AMI) with and without out-of-hospital cardiac arrest (OHCA). METHODS: Prospective cohort study of all AMI patients admitted to Oslo University Hospital Ulleval from September 1, 2005 to December 31, 2011. All-cause mortality was obtained from the Norwegian Cause of Death Registry with censoring date December 31, 2013. Cumulative survival was assessed with the Kaplan-Meier and the Life-table method. Logistic- and Cox regression were used for risk comparisons. RESULTS: We identified 404 AMI patients with OHCA and 9425 AMI patients without. AMI patients without OHCA were categorized as ST-elevation myocardial infarction (STEMI, n=4522) or non-STEMI (NSTEMI, n=4903). Mean age was 63.6±standard deviation (SD) 12.5, 63.8±13.1 and 69.7±13.6 years in OHCA, STEMI and NSTEMI, respectively. Coronary angiography with subsequent percutaneous coronary intervention if indicated, was performed in 87% of OHCA, 97% of STEMI and 80% of NSTEMI patients. Thirty-day survival was 63%, 94% and 94%, and 8-year survival was 49%, 74%, and 57%, respectively. Among patients surviving the first 30days, no significant difference in risk during long-term follow-up was found (adjusted Hazard Ratio (aHR)OHCAvsSTEMI 1.15 [95% CI 0.82-1.60], aHROHCAvsNSTEMI 0.89 [95% CI 0.64-1.24]). CONCLUSIONS: Long-term survival after OHCA due to AMI was good, with 49% of admitted patients being alive after eight years. Although short-term mortality remained high, OHCA patients alive after 30days had similar long-term risk as AMI patients without OHCA.
Authors: Simon A Amacher; Chantal Bohren; René Blatter; Christoph Becker; Katharina Beck; Jonas Mueller; Nina Loretz; Sebastian Gross; Kai Tisljar; Raoul Sutter; Christian Appenzeller-Herzog; Stephan Marsch; Sabina Hunziker Journal: JAMA Cardiol Date: 2022-06-01 Impact factor: 30.154