Which factors are linked to out-of-hospital cardiac arrest?

01 Nov 2020
High-dose nifedipine tied to greater cardiac arrest risk

Out-of-hospital cardiac arrest (OHCA) is associated with younger age, no use of calcium-channel antagonists, worse renal function, larger infarct size, culprit lesion in the left main coronary artery, and having chronic total occlusion, a study has found.

The authors characterized the clinical and angiographic features of acute myocardial infarction (AMI) in patients with OHCA compared to those without OHCA in this retrospective analysis of 480 consecutive patients with AMI undergoing percutaneous coronary intervention.

Of the patients, 141 (29 percent) were complicated with OHCA. In multivariate analysis, the following factors were significantly associated with OHCA: age (odds ratio [OR], 0.8, 95 percent confidence interval [CI], 0.7–0.9 per 5 years; p<0.001), estimated glomerular filtration rate (OR, 0.8, 95 percent CI, 0.7 to 0.8 per 10 ml/min/1.73 m2; p<0.001), peak creatinine kinase myocardial band (OR, 1.3, 95 percent CI, 1.2–1.4 per 102 U/I; p<0.001), use of calcium-channel antagonists (OR, 0.4, 95 percent CI, 0.2–0.7; p=0.002), the culprit lesion at the left main coronary artery (OR, 5.3, 95 percent CI, 1.9–15.1; p=0.002), and the presence of chronic total occlusion (OR, 2.9, 95 percent CI, 1.5–5.7; p=0.001).

“Sudden cardiac arrest is a serious complication of AMI,” the authors said. “Although in-hospital mortality from MI has decreased, the mortality of MI patients complicated with OHCA remains high.”

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