Clinical profiling and prognosis of out-of-hospital cardiac arrest in ST-segment elevation myocardial infarction in an Asian population
Year: 2025
Type: article
Abstract: Objectives: Out-of-hospital cardiac arrest (OHCA) is a major cause of mortality in patients with ST-segment elevation myocardial infarction (STEMI). However, the clinical characteristics and prognostic outcomes of STEMI patients who experience OHCA remain poorly understood. Methods: Using data from the CCC-ACS (Improving Care for Cardiovascular Disease in China - Acute Coronary Syndrome) project, we analyzed data from 70,901 patients with STEMI. Multivariable regression models were used to evaluate the associations between patient characteristics and the occurrence of OHCA as well as subsequent in-hospital cardiac arrest (IHCA). Results: Among the 70,901 STEMI patients included in this national retrospective cohort study, 1.9 % experienced OHCA, of whom 35.1 % subsequently developed IHCA. Ten independent predictors of OHCA were identified, including a history of atrial fibrillation, chronic heart failure, chronic renal failure, diabetes mellitus, ischemic stroke, culprit lesions in the left main coronary artery (LMCA), left circumflex artery (LCX), or right coronary artery (RCA), and the use of antiplatelet agents or angiotensin-converting enzyme inhibitors/angiotensin II receptor blockers (ACEI/ARB). IHCA was the strongest predictor of in-hospital mortality among OHCA patients, with four factors independently associated with IHCA: advanced age, female gender, Killip class IV, and absence of standard modifiable cardiovascular risk factors (SMuRF-less). Percutaneous coronary intervention (PCI) and timely medical treatment (statins, ACEI/ARB, and mineralocorticoid receptor antagonists [MRA]) are critical for preventing IHCA. Conclusions: OHCA is a rare but highly fatal complication in STEMI patients. A multitude of factors are associated with OHCA and subsequent IHCA, laying the groundwork for early risk stratification and optimized treatment strategies to enhance patient outcomes.
Source: Resuscitation Plus
Authors: Shuo Pang, Chu Fan, Shen Wang, Yue Wang, Xiaofan Wu, Aihua Li, Bao Li, Biao Xu, Guangshu Han, Bin Li, Bin Liu, Bin Wang, Bing Fu, Bo Yu, Bosong Yang, Caidong Luo, Changqian Wang, Changyong Liu, Chuanliang Liang, Chuanyu Gao, Chunlin Lai, Chuntong Wang, Chunyan Zhang, Chunyang Wu, Congliang Zhang, Cui Bin, Lan Huang, Daoquan Peng, Dawen Xu, Di Wu, Dongmei Zhu, Dongsheng Chai, Dongyan Li, Fakuan Tang, Jun Xiao, Fang Zhao, Fangfang Huang, Fanju Meng, Fengwei Li, Fudong Gan, Gang Xu, Gengsheng Sang, Genshan Ma, Guixia Zhang, Guizhou Tao, Guo Li, Guoduo Chen, Guoqin Xin, Guoqing Li, Guosheng Fu, Guoxiong Chen, Hailong Lin, Haiping Guo, Haiyun Lin, Hong Jiang, Hong Liu, Hong Luan, Hong Zhang, Honghua Deng, Hongwei Li, Honhju Wang, Hualing Liu, Hui Dong, Hui Liu, Huifang Zhang, Huifeng Wang, Huimin Chu, Jiabin Xi, Jian Yang, Jianfeng Ye, Jianhao Li, Jianhong Tao, Jianwen Liu, JiaoMei Yang, Jiawang Ding, Jiayi Tong, Jie Chen, Jie Jiang, Jie Yang, Jifu Li, Jinchuan Yan, Jing Hu, Jing Xu, Jingfeng Wang, Jinglan Diao, Jingshan Zhao, Jinru Wei, Jinxing Yi, Jinzi Su, Jiong Tang, Jiyan Chen, Jiyan Yin, Juexin Fan, Jun Guan, Junbo Ge, Junming Liu, Junping Deng, Junping Fang, Junxia Li, Kaihong Chen, Kalan Luo, Keng Wu, Lang Ji, Lang Li, Li Jiang, Li Wei, Lijun Meng, Likun Ma, Lilong Tang, Lin Wang, Lin Wei, Ling Li, Ling Tao, Liqiong Yang, Lirong Wu, Man Zhang, Kaiming Chen, Meisheng Lai, Miao Tian, Mingcheng Bai, Minghua Han, Moshui Chen, Naiyi Liang, Nan Jia, Peiying Zhang, Peng Qu, Pengfei Zhang, Ping Chen, Ping Hou, Ping Xie, Ping Zhang, Pingshuan Dong, Qiang Wu, Qiang Xie, Qiaoqing Zhong, Qichun Wang, Qinfeng Su, Rong Chang, Rong Lin, Ruiping Zhao, Shaobin Jia, Shaoping Nie, Shaowu Ye, Shenghu He, Shengyong Chen, Shixin Ma, Shuangbin Li, Shuanli Xin, Shudong Xia, Shuhua Zhang, Shuqiu Qu, Shuren Ma, Siding Wang, Songbai Li, Suxin Luo, Tao Liu, Tao Zhang, Tian Tuo, Tianchang Li, Tianlun Yang, Tianmin Du, Tongguo Wu, Wei Liu, Wei Mao, Wei Tuo, Wei Wang, Weihong Jiang, Weijian Huang, Weijun Liu, Weiqing Fan, Weiting Xu, Wenhua Lin, Xi Su, Xia Chen, Xianan Zhang, Xianghua Fu, Xiangjun Yang, Xianxian Zhao, Xiaochuan Ma, Xiaofei Sun, Xiaojun Wang, Xiaolan Li, Xiaolei Li, Xiaoli Yang, Xiaoping Chen, Xiaoping Chen, Xiaoqin Zhang, Xiaoshu Cheng, Xiaowei Peng, Xiaowen Ma, Xiaoyong Qi, Xiaoyun Feng, Ximing Chen, Xin Tang, Xingsheng Tang, Xingsheng Zhao, Xiufeng Chen, Xudong Li, Xue Li, Xuebo Liu, Xuemei Peng, Yaling Han, Yan Wang, Yanbo Niu, Yang Yu, Yang Zheng, Yanli Wang, Yanlie Zheng, Yansong Guo, Yanzong Yang, Yi Huang, Yin Liu, Ying Guo, Yingchao Luo, Yinglu Hao, Yingxian Sun, Yingzhong Lin, Yitong Ma, Yong Guo, Yong Li, Yongdong Li, Yonglin Zhang, Yuanzhe Jin, Yue Li, Yuehua Huang, Yuemin Sun, Yuheng Yang, Yuhua Zhu, Yuhuan Shi, Yulan Zhao, Yuqing Hou, Zeqi Zheng, Zesheng Xu, Zewei Ouyang, Zeyuan He, Zhan Lv, Zhanquan Li, Zhaofa He, Zheng Ji, Zheng Zhang, Zhenguo Ji, Zhenqi Su, Zhenyu Yang, Zhihong Ou, Zhijian Yang, Zhiming Yang, Zhirong Wang, Zhiyuan Song, Zhongshan Wang, Zuyi Yuan
Institutions: Capital Medical University, Beijing Anzhen Hospital
Language: English
Subfield: Cardiology and Cardiovascular Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $2,450
Awards: G1178206629, G189367280
OpenAlex ID: W4416589113