Abstract 19529: Risk of Sudden Cardiac Arrest According to the Month of STEMI Occurrence: The e-MUST Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicole Karam ◽  
Muriel Tafflet ◽  
Sophie Bataille ◽  
Eloi Marijon ◽  
Jean Philippe empana ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Emergency Medical Services ◽  
Cause Of Death ◽  
Sudden Cardiac Arrest ◽  
Temporal Changes ◽  
Pathophysiological Mechanisms ◽  
Hospital Study ◽  
Suspected Acute Myocardial Infarction

STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main cause of death. The risk of SCA according to the month of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA varies according to the month of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed and compared the rate of SCA according to the month of STEMI occurrence. Results: Among the 8112 STEMI patients enrolled (mean age (SD) 61.6years (14.3), 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant temporal changes in the rate of SCA per STEMI over the year. The peak rate of SCA per STEMI occurred in June (8.7%), while the lowest rate was in December (3.45%) (Figure). Conclusions: The risk of SCA varies significantly according to the month of STEMI occurrence, with STEMI occurring in June being at the highest risk for SCA while those occurring in December have the lowest risk. A better understanding of the pathophysiological mechanisms of this difference is needed to eventually reduce the risk of out-of-hospital SCA after STEMI diagnosis.

Abstract 13027: Risk of Sudden Cardiac Arrest According to the Time of STEMI Occurrence: the e-MUST Study

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Nicole Karam ◽  
Sophie Bataille ◽  
Muriel Tafflet ◽  
Eloi Marijon ◽  
Jean Philippe Empana ◽  
...  
Keyword(s):  
Cardiac Arrest ◽  
Hospital Admission ◽  
Sudden Cardiac Arrest ◽  
Progressive Increase ◽  
Time Interval ◽  
Main Mode ◽  
Time Intervals ◽  
Circadian Change ◽  
Hospital Study ◽  
Suspected Acute Myocardial Infarction

Introduction: STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main mode of death. The risk of out-of-hospital SCA according to the timing of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA, prior to hospital admission, differs according to the timing of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on all STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send, in the field, an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed the rate of SCA, prior to hospital admission, according to the timing of STEMI occurrence (4 hours-time intervals starting at midnight). Results: Among the 8,112 STEMI patients enrolled (mean age (SD) 61.6 (14.3) years, 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant circadian change in the rate of SCA per STEMI, with a progressive increase between 4am and 8pm, followed by a decrease between 8pm and 4am (P=0.0009). The peak rate of SCA per STEMI occurred in the 4pm-8pm time interval (7.7%), while the lowest rate was seen between 4am and 8am (4.2%) (Figure). Conclusions: The risk of STEMI-related SCA is almost 2-fold higher in STEMI occurring in the late afternoon hours. A better understanding of patients’ characteristics, circumstances of occurrence, and pre-hospital care is needed to eventually reduce the risk of SCA promptly after STEMI diagnosis in the field.

Acute myocardial infarction complicated by sudden cardiac arrest in a patient with ulcerative colitis

2010 ◽  
Vol 21 (4) ◽  
pp. 477-479
Author(s):  
Altug SENOL ◽  
Mehmet ISLER ◽  
Mehmet OZAYDIN ◽  
Yasin TURKER ◽  
Yildiran SONGUR ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Ulcerative Colitis ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Sudden Cardiac Arrest

Impact of arterial stiffness on diastolic function and outcomes of heart failure in patients presenting with acute myocardial infarction

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
K Kim ◽  
M.G Kang ◽  
J.S Koh ◽  
J.R Park ◽  
S.J Hwang ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Heart Failure ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Arterial Stiffness ◽  
Diastolic Dysfunction ◽  
Diastolic Function ◽  
Cardiac Death ◽  
Sudden Cardiac Arrest ◽  
Low Bmi

Abstract Background Relation of arterial stiffness and cardiovascular disease is well-known. However, there is no data on association between diastolic function and brachial-ankle pulse wave velocity (baPWV) and influence on heart failure outcomes in patients with acute myocardial infarction (AMI). Methods Among patients presenting with AMI, all subjects underwent baPWV and echocardiography were recruited. Diastolic function was categorized by 2016 guideline of ASE/EACVI left ventricular diastolic function. Heart failure outcomes were defined 1) hospitalization for heart failure, 2) cardiac death and 3) sudden cardiac arrest. Results Totally 1,016 subjects were enrolled (FU duration; 3.5±2.0 years, mean age 65±13, predominant male 71.3% and STEMI 40.8%) from 2012 to 2015 in the our University Hospital. Elderly, female, low BMI, higher PWV, HTN, DM and stroke were associated with higher baPWV. Increased arterial stiffness (defined as baPWV ≥1700) had higher prevalence of diastolic dysfunction compared with baPWV <1700 (98.3% vs 86.2%). HF outcomes of 69 events were identified (HF; n=48, cardiac death; n=16, sudden cardiac arrest; n=2, death d/t HF; n=3). In the multivariate analysis, baPWV ≥1700, HTN and low BMI (23 kg/m2) were independent predictors for HF outcomes after adjustment with age, LVEF, DM and stroke (Table 1). Furthermore, KM curve showed that increased arterial stiffness was associated with higher prevalence of diastolic dysfunction and poor outcomes of heart failure (Figure 1). Conclusions In patients with AMI, arterial stiffness was associated with higher prevalence of diastolic dysfunction an independent predictor for heart failure hospitalization and cardiac death. Figure 1. Diastolic dysfunction and HF in AMI Funding Acknowledgement Type of funding source: None

scholarly journals Admission biomarkers among patients with acute myocardial-infarction related cardiogenic shock with or without out-of-hospital cardiac arrest

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
M Thoegersen ◽  
M Frydland ◽  
O Helgestad ◽  
LO Jensen ◽  
J Josiassen ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Cardiogenic Shock ◽  
Plasma Concentrations ◽  
Endothelial Damage ◽  
Soluble Thrombomodulin ◽  
Catheterization Laboratory ◽  
Hospital Cardiac Arrest

Abstract Funding Acknowledgements Type of funding sources: Foundation. Main funding source(s): Lundbeck Foundation OnBehalf Critical Cardiac Care Research Group Background Approximately half of all patients with acute myocardial infarction complicated by cardiogenic shock (AMICS) present with out-of-hospital cardiac arrest (OHCA). Cardiogenic shock due to OHCA is caused by abrupt cessation of circulation, whereas AMICS without OHCA is due to cardiac failure with low cardiac output. Thus, there may also be differences between the two conditions in terms of blood borne biomarkers. Purpose To explore the potential differences in the admission plasma concentrations of biomarkers reflecting tissue perfusion (lactate), neuroendocrine response (mid-regional proadrenomedullin [MRproADM], Copeptin, pro-atrial natriuretic peptide [proANP]), endothelial damage (Syndecan-1, soluble thrombomodulin [sTM]), inflammation (soluble suppression of tumorigenicity 2 [sST2]) and kidney injury (neutrophil gelatinase-associated lipocalin [NGAL]), in patients with AMICS presenting with or without OHCA. Method Consecutive patients admitted for acute coronary angiography due to suspected ST-elevation myocardial infarction (STEMI) were enrolled during a 1-year period. A total of 2,713 patients were screened. In the present study 86 patients with confirmed STEMI and CS at admission were included. Results Patients with OHCA (had significantly higher median admission concentrations of Lactate (6,9 mmol/L vs. 3.4 mmol/L p <0.001), NGAL (220 ng/ml  vs 150 ng/ml p = 0.046), sTM (10 ng/ml vs. 8.0  ng/ml p = 0.026) and Syndecan-1 (160 ng/ml vs. 120 ng/ml p= 0.015) and significantly lower concentrations of MR-proADM (0.85 nmol/L  vs. 1.6 nmol/L p <0.001) and sST2 (39 ng/ml vs. 62 ng/ml p < 0.001).  After adjusting for age, sex, and time from symptom onset to coronary angiography, lactate (p = 0.008), NGAL (p = 0.03) and sTM (p = 0.011) were still significantly higher in patients presenting with OHCA while sST2 was still significantly lower (p = 0.029). There was very little difference in 30-day mortality between the OHCA and non-OHCA groups (OHCA 37% vs. non-OHCA 38%). Conclusion Patients with STEMI and CS at admission with or without concomitant OHCA had similar 30-day mortality but differed in terms of Lactate, NGAL, sTM and sST2 levels at the time of admission to catheterization laboratory. These findings propose that non-OHCA and OHCA patients with CS could be considered as two individual clinical entities. Abstract Figure. Level of biomarkers OHCA vs. non-OHCA

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