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Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest

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@article{b3615e4a460e4a3fa8f4432886c77d79,
title = "Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest",
abstract = "AIMS: Out-of-hospital cardiac arrest (OHCA) is highly prevalent among patients with myocardial infarction and cardiogenic shock (MI-CS). We aimed to examine the prognostic importance of OHCA in patients with MI-CS.METHODS: Using Danish nationwide registries, we identified first-time hospitalized MI-CS patients (2010-2015) by OHCA status. Cumulative incidence curves and adjusted Cox regression models were used to compare in-hospital mortality, and among hospital survivors we compared 5-year rates of heart failure hospitalization and mortality.RESULTS: We identified 3107 MI-CS patients of whom 979 presented with OHCA (32%). OHCA patients were younger (median age: 65 vs. 74 years) and had less comorbidity. In-hospital mortality was 57% in those with OHCA compared with 67% in those without, but after adjustment the hazard ratio (HR) was 0.99 [95% CI: 0.87-1.11]. Hospital survivors consisted of 1375 MI-CS patients including 531 OHCA patients (39%). Five-year mortality was 22% for OHCA patients and 42% for patients without OHCA (adjusted HR: 0.90 [95% CI: 0.70-0.1.17]). The HR for five-year cardiovascular mortality was 0.80 [95% CI: 0.62-0.98]. Lastly, 5-year rate of heart failure hospitalization was 17% for patients with OHCA compared with 34% in those without (HR: 0.44 [95% CI: 0.34-0.57]).CONCLUSION: Among patients hospitalized with MI-CS, OHCA did not influence all-cause in-hospital or long-term mortality but was a marker for reduced long-term rates of heart failure hospitalization and cardiovascular mortality. Future randomized studies are needed to improve prognosis of MI-CS, however, the importance of OHCA must be considered.",
keywords = "Cardiac arrest, Cardiogenic shock, Epidemiology, Myocardial infarction, Prognosis",
author = "Lauridsen, {Marie D} and Jakob Josiassen and Morten Schmidt and Butt, {Jawad H} and Lauge {\O}stergaard and Morten Schou and Jesper Kj{\ae}rgaard and M{\o}ller, {Jacob E} and Christian Hassager and Christian Torp-Pedersen and Gunnar Gislason and Lars K{\o}ber and Fosb{\o}l, {Emil L}",
note = "Copyright {\textcopyright} 2021 Elsevier B.V. All rights reserved.",
year = "2021",
month = may,
day = "1",
doi = "10.1016/j.resuscitation.2021.02.034",
language = "English",
volume = "162",
pages = "135--142",
journal = "Resuscitation",
issn = "0300-9572",
publisher = "Elsevier Ireland Ltd",

}

RIS

TY - JOUR

T1 - Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest

AU - Lauridsen, Marie D

AU - Josiassen, Jakob

AU - Schmidt, Morten

AU - Butt, Jawad H

AU - Østergaard, Lauge

AU - Schou, Morten

AU - Kjærgaard, Jesper

AU - Møller, Jacob E

AU - Hassager, Christian

AU - Torp-Pedersen, Christian

AU - Gislason, Gunnar

AU - Køber, Lars

AU - Fosbøl, Emil L

N1 - Copyright © 2021 Elsevier B.V. All rights reserved.

PY - 2021/5/1

Y1 - 2021/5/1

N2 - AIMS: Out-of-hospital cardiac arrest (OHCA) is highly prevalent among patients with myocardial infarction and cardiogenic shock (MI-CS). We aimed to examine the prognostic importance of OHCA in patients with MI-CS.METHODS: Using Danish nationwide registries, we identified first-time hospitalized MI-CS patients (2010-2015) by OHCA status. Cumulative incidence curves and adjusted Cox regression models were used to compare in-hospital mortality, and among hospital survivors we compared 5-year rates of heart failure hospitalization and mortality.RESULTS: We identified 3107 MI-CS patients of whom 979 presented with OHCA (32%). OHCA patients were younger (median age: 65 vs. 74 years) and had less comorbidity. In-hospital mortality was 57% in those with OHCA compared with 67% in those without, but after adjustment the hazard ratio (HR) was 0.99 [95% CI: 0.87-1.11]. Hospital survivors consisted of 1375 MI-CS patients including 531 OHCA patients (39%). Five-year mortality was 22% for OHCA patients and 42% for patients without OHCA (adjusted HR: 0.90 [95% CI: 0.70-0.1.17]). The HR for five-year cardiovascular mortality was 0.80 [95% CI: 0.62-0.98]. Lastly, 5-year rate of heart failure hospitalization was 17% for patients with OHCA compared with 34% in those without (HR: 0.44 [95% CI: 0.34-0.57]).CONCLUSION: Among patients hospitalized with MI-CS, OHCA did not influence all-cause in-hospital or long-term mortality but was a marker for reduced long-term rates of heart failure hospitalization and cardiovascular mortality. Future randomized studies are needed to improve prognosis of MI-CS, however, the importance of OHCA must be considered.

AB - AIMS: Out-of-hospital cardiac arrest (OHCA) is highly prevalent among patients with myocardial infarction and cardiogenic shock (MI-CS). We aimed to examine the prognostic importance of OHCA in patients with MI-CS.METHODS: Using Danish nationwide registries, we identified first-time hospitalized MI-CS patients (2010-2015) by OHCA status. Cumulative incidence curves and adjusted Cox regression models were used to compare in-hospital mortality, and among hospital survivors we compared 5-year rates of heart failure hospitalization and mortality.RESULTS: We identified 3107 MI-CS patients of whom 979 presented with OHCA (32%). OHCA patients were younger (median age: 65 vs. 74 years) and had less comorbidity. In-hospital mortality was 57% in those with OHCA compared with 67% in those without, but after adjustment the hazard ratio (HR) was 0.99 [95% CI: 0.87-1.11]. Hospital survivors consisted of 1375 MI-CS patients including 531 OHCA patients (39%). Five-year mortality was 22% for OHCA patients and 42% for patients without OHCA (adjusted HR: 0.90 [95% CI: 0.70-0.1.17]). The HR for five-year cardiovascular mortality was 0.80 [95% CI: 0.62-0.98]. Lastly, 5-year rate of heart failure hospitalization was 17% for patients with OHCA compared with 34% in those without (HR: 0.44 [95% CI: 0.34-0.57]).CONCLUSION: Among patients hospitalized with MI-CS, OHCA did not influence all-cause in-hospital or long-term mortality but was a marker for reduced long-term rates of heart failure hospitalization and cardiovascular mortality. Future randomized studies are needed to improve prognosis of MI-CS, however, the importance of OHCA must be considered.

KW - Cardiac arrest

KW - Cardiogenic shock

KW - Epidemiology

KW - Myocardial infarction

KW - Prognosis

UR - http://www.scopus.com/inward/record.url?scp=85101931660&partnerID=8YFLogxK

U2 - 10.1016/j.resuscitation.2021.02.034

DO - 10.1016/j.resuscitation.2021.02.034

M3 - Journal article

C2 - 33662522

VL - 162

SP - 135

EP - 142

JO - Resuscitation

JF - Resuscitation

SN - 0300-9572

ER -

ID: 64042020