Relation of Chronic Total Occlusion to In-Hospital Mortality in the Patients With Sudden Cardiac Arrest Due to Acute Coronary Syndrome

2019 ◽  
Vol 123 (12) ◽  
pp. 1915-1920
Author(s):  
Kazuya Shinouchi ◽  
Yasunori Ueda ◽  
Taishi Kato ◽  
Hiroki Nishida ◽  
Tatsuhisa Ozaki ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Chronic Total Occlusion ◽  
Sudden Cardiac Arrest ◽  
Total Occlusion ◽  
Coronary Syndrome

scholarly journals Sudden Cardiac Arrest as the First Manifestation of Takayasu Arteritis

2020 ◽  
pp. 1-2
Author(s):  
Stephane Manzo-Silberman ◽  
Stephane Manzo-Silberman ◽  
Alix de Gonneville ◽  
Martin Nicol ◽  
Sylvie Meireles ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Takayasu Arteritis ◽  
Immunosuppressive Treatment ◽  
Sudden Cardiac Arrest ◽  
Young Patients ◽  
Optimal Care ◽  
Total Occlusion ◽  
Coronary Syndrome ◽  
Shockable Rhythm ◽  
First Case

Management of out-of-hospital cardiac arrest (OHCA) remains challenging, particularly in young patients. Takayasu arteritis is a rare large-vessel vasculitis relatively. Coronary involvement has been previously described; we provided the first intracoronary images by OCT. We report the first case of OHCA with shockable rhythm revealing chronic total occlusion of the left main in a 41-year-old lady. The coronary anomaly made it possible to diagnose the vasculitis and to treat it by corticosteroid and immunosuppressive treatment. Vasculitis should be evoked in atypical coronary syndrome in young patients. A collaborative multidisciplinary approach permits optimal care for this complex patient.

scholarly journals Predictor of in-hospital mortality among acute coronary syndrome patients after treatment with an intra-aortic balloon pump in tertiary Hospital, Thailand

2020 ◽  
Vol 72 (6) ◽  
pp. 462-469
Author(s):  
Chorchana Wichian ◽  
Thotsaporn Morasert ◽  
Surat Tongyoo ◽  
Naruebeth Koson
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Cardiogenic Shock ◽  
Predictive Factors ◽  
Killip Class ◽  
Hemodynamic Support ◽  
Factors Associated ◽  
Coronary Syndrome ◽  
Class Iv

Objective: Intra-aortic balloon pump (IABP), a mechanical hemodynamic support device, had widely been used to treat cardiogenic shock patients for several decades. However, the information about the predictive factors associated with mortality was scarce. This study aims to identify the predictive factors associated with in-hospital mortality in acute coronary syndrome (ACS) patients who performed IABP for their hemodynamic support during admission.Methods: We conduct a retrospective cohort study design. All admission records of ACS patients with IABP at Suratthani Hospital between October 2015 and September 2019 were retrieved.Results: Overall 75 ACS patients with IABP insertion were enrolled. Thirty-one patients died during admission, in-hospital mortality was 41.3%. From the multivariable analysis, we identified 3 predictors associated with in-hospital mortality included cardiac arrest at presentation (adjusted OR [aOR]=11.18, 95%CI: 2.42-51.57, P=0.002), a higher number of inotropes or vasopressors (aOR 6.10, 95%CI 1.36-27.24, P=0.018) and Killip class IV (aOR 5.64, 95%CI 1.01-31.39, P=0.048).Conclusion: ACS patients who required IABP support had high mortality. Cardiac arrest, Killip class IV (cardiogenic shock) at presentation and requiring a higher number of inotropes or vasopressors were independent predictive factors of in-hospital mortality.

Canadian Multicenter Chronic Total Occlusion Registry: Ten-Year Follow-Up Results of Chronic Total Occlusion Revascularization

2021 ◽  
Vol 14 (12) ◽  
Author(s):  
Bradley H. Strauss ◽  
Merril L. Knudtson ◽  
Asim N. Cheema ◽  
P. Diane Galbraith ◽  
Gabby Elbaz-Greener ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Chronic Total Occlusion ◽  
Artery Bypass ◽  
Hazard Ratio ◽  
Lower Mortality ◽  
Time Varying ◽  
Total Occlusion ◽  
Chronic Total Occlusions ◽  
Coronary Syndrome ◽  
All Cause Mortality

Background: Chronic total occlusions (CTO) occur in nearly 20% of coronary angiograms. CTO revascularization, either by percutaneous coronary intervention (PCI) or coronary artery bypass grafting surgery (CABG), is infrequently performed, approximately one-third of cases. Long-term outcomes are unknown. The objective of the study was to determine whether early CTO revascularization of patients, either by CABG or PCI, was associated with improved clinical outcomes. Methods: One thousand six hundred twenty-four patients from the Canadian CTO registry were followed for at least 9.75 years. Revascularization was performed according to routine clinical practice. Patients were grouped according to CTO revascularization status (PCI or CABG of CTO vessel, CTO revasc) or no CTO revasc (medical therapy only, or PCI/CABG of non-CTO vessels only), within 3 months of initial angiogram. Patients were followed for mortality, revascularization procedures (PCI and CABG), and hospitalizations for acute coronary syndromes and heart failure. Results: Early CTO revasc was performed in 28.2% of patients (17.5% CABG, 10.7% PCI). The CTO revasc group was younger, with more males and generally fewer comorbidities. There was a significantly lower mortality probability at 10 years in the CTO revascularization group (22.7% [95% CI, 19.0%–26.9%]) compared with the no CTO revasc group (36.6% [95% CI, 33.8%–39.5%]). At 10 years, revascularization rates (14.0% versus 22.8%) and acute coronary syndrome hospitalization rates (10.0% versus 16.6%) were significantly lower in the CTO revasc group. Baseline-adjusted analysis showed CTO revasc was associated with significantly lower all-cause mortality (hazard ratio, 0.67 [95% CI, 0.54–0.84]). In both landmark and time varying analyses, association with lower mortality was particularly robust for CTO revascularization by CABG (hazard ratio 0.56 and 0.60, respectively), with a marginally significant result for PCI in the time varying analysis (hazard ratio 0.711 [95% CI, 0.51–0.998]). Conclusions: Early CTO revascularization was associated with significantly lower all-cause mortality, revascularization rates, and hospitalization for acute coronary syndrome at 10 years, and mainly driven by outcomes in patients with CABG.

scholarly journals Mortality & COVID-19: A Snapshot of a Tertiary Care Facility in Pakistan (Preprint)

2020 ◽  
Author(s):  
Muhammad Asim Rana ◽  
Ahad Qayyum ◽  
Mubashar Hashmi ◽  
Muhammad Muneeb Ullah Saif ◽  
Muhammad Faisal Munir ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Acute Respiratory Distress Syndrome ◽  
Retrospective Study ◽  
Distress Syndrome ◽  
Sudden Cardiac Arrest ◽  
Single Center ◽  
Coronary Syndrome ◽  
Biochemical Profiles ◽  
Multiorgan Dysfunction Syndrome

BACKGROUND Introduction: Ever since Sars CoV-2 infection has started from China and has taken the shape of pandemic the mortality associated with this disease has been under discussion and hypercoagubility, acute severe respiratory syndrome and sepsis with multi organ failure have been accursed as possible reasons of deaths in cases infected with novel Corona virus. We conducted a retrospective analysis of the cases admitted in our high dependency and Intensive care unit and tried to pinpoint the major cause of mortality in our cases. Methods: This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3 month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. Results: A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. Conclusion: Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients. OBJECTIVE To evaluate major cause of mortality in our COVID 19 cases. METHODS This is a single center retrospective study carried out at Bahria International Hospital Lahore over a 3 month period (May 10th to July 10th 2020) in which we analyzed the clinical and biochemical profiles of the COVID-19 patients who died during this period. RESULTS A total of 108 patients were admitted during this period out of which 11 patients died. 7 of them were men and 4 women. Majority of them had sudden cardiac arrest due to acute coronary syndrome followed by multiorgan dysfunction syndrome and acute respiratory distress syndrome. CONCLUSIONS Acute coronary syndrome due to hypercoagubility was the leading cause of death in our patients.

scholarly journals An observational study assessing the impact of a cardiac arrest centre on patient outcomes after out-of-hospital cardiac arrest (OHCA)

2020 ◽  
Vol 9 (4_suppl) ◽  
pp. S67-S73
Author(s):  
Matthew Kelham ◽  
Timothy N Jones ◽  
Krishnaraj S Rathod ◽  
Oliver Guttmann ◽  
Alastair Proudfoot ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Coronary Intervention ◽  
Stepwise Logistic Regression ◽  
Coronary Syndrome ◽  
Before And After ◽  
The Impact ◽  
Hospital Cardiac Arrest ◽  
Baseline Demographic

Background: Out-of-hospital cardiac arrest (OHCA) is a major cause of death worldwide. Recent guidelines recommend the centralisation of OHCA services in cardiac arrest centres to improve outcomes. In 2015, two major tertiary cardiac centres in London merged to form a large dedicated tertiary cardiac centre. This study aimed to compare the short-term mortality of patients admitted with an OHCA before-and-after the merger of services had taken place and admission criteria were relaxed, which led to managing OHCA in higher volume. Methods: We retrospectively analysed the data of OHCA patients pre- and post-merger. Baseline demographic and medical characteristics were recorded, along with factors relating to the cardiac arrest. The primary endpoint was in-hospital mortality. Results: OHCA patients ( N =728; 267 pre- and 461 post-merger) between 2013 and 2018 were analysed. Patients admitted pre-merger were older (65.0 vs. 62.4 years, p=0.027), otherwise there were similar baseline demographic and peri-arrest characteristics. There was a greater proportion of non-acute coronary syndrome-related OHCA admission post-merger (10.1% vs. 23.4%, p=0.0001) and a corresponding decrease in those admitted with ST-elevation myocardial infarction (80.2% vs. 57.0%, p=0.0001) and those treated with percutaneous coronary intervention (78.8% vs. 54.0%, p=0.0001). Despite this, in-hospital mortality was lower post-merger (63.7% vs. 44.3%, p=0.0001), which persisted after adjustment for demographic and arrest-related characteristics using stepwise logistic regression ( p=0.036) between the groups. Conclusion: Despite an increase in non-acute coronary syndrome-related OHCA cases, the formation of a centralised invasive heart centre was associated with improved survival in OHCA patients. This suggests there may be a benefit of a cardiac arrest centre model of care.

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