scholarly journals Validation of different score systems in predicting cardiac arrest occurrence of ST-elevation myocardial infarction

2017 ◽  
Vol 24 (5) ◽  
pp. 224-229
Author(s):  
Ko-Wen Han ◽  
Shou-Yen Chen ◽  
Yi-Ming Weng ◽  
Chip-Jin Ng ◽  
Te-Fa Chiu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Emergency Department ◽  
Cardiac Arrest ◽  
Risk Score ◽  
Coronary Event ◽  
St Elevation Myocardial Infarction ◽  
Acute Coronary Event ◽  
Event Risk ◽  
St Elevation ◽  
Global Registry

Introduction: Patients with ST-elevation myocardial infarction are at risk of developing cardiac arrest. A validated tool for predicting cardiac arrest would help physicians recognize these high-risk patients earlier. This study assessed the usefulness of various score systems in predicting cardiac arrest in patients hospitalized for ST-elevation myocardial infarction. Methods: Patients’ data were retrieved from the hospital’s ST-elevation myocardial infarction registry records. Patients aged 18 years or older seen at the emergency department with a diagnosis of ST-elevation myocardial infarction between 1 July 2013 and 30 June 2014 were enrolled. The Thrombolysis in Myocardial Infarction score, the 6-month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART score were calculated and compared. Results: A total of 249 patients were recruited. The Thrombolysis in Myocardial Infarction score, 6-month Global Registry of Acute Coronary Event risk score, CHADS2 score, and HEART scores were calculated. In total, 41 (16.5%) patients had cardiac arrest at emergency department or during hospitalization and 12 (29.3%) of them survived. The 6-month Global Registry of Acute Coronary Event risk score had the biggest area under the receiver-operating characteristic curve (0.72). Conclusion: The 6-month Global Registry of Acute Coronary Event risk score is more useful in predicting cardiac arrest in patients hospitalized for ST-elevation myocardial infarction than the other three scores. It is recommended that the 6-month Global Registry of Acute Coronary Event risk score be calculated for identifying emergency department patients hospitalized for ST-elevation myocardial infarction who are at risk of cardiac arrest during their hospital stay.

Abstract 341: A Simple Prognostic Tool for In-Hospital Death in Patients Presenting with Out-of-Hospital Cardiac Arrest and ST-Elevation Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_4) ◽  
Author(s):  
Andy T Tran ◽  
Anthony J Hart ◽  
John Spertus ◽  
Philip Jones ◽  
Ali O Malik ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Arrest ◽  
Coronary Angiography ◽  
Hospital Mortality ◽  
Risk Score ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Hospital Death ◽  
St Elevation ◽  
Hospital Cardiac Arrest

Background: In the emergent setting of ST-Elevation Myocardial Infarction (STEMI) complicating out-of-hospital cardiac arrest (OHCA), decisions for immediate coronary angiography are made when the likelihood of hospital survival is unknown. Estimating the risk of mortality at the time of hospital arrival might inform decisions for primary percutaneous coronary intervention. Methods: From the Cardiac Arrest Registry to Enhance Survival (CARES), we included adult OHCA patients from 2013-2018 presenting to hospitals with a STEMI. We developed a predictive model for in-hospital mortality using multivariable logistic regression to derive a scoring tool that was internally validated with bootstrap methods. Results: Of 7120 patients with OHCA and STEMI admitted at a hospital (mean age 62±13.2 years, 27% female), 3159 (44.4%) died during hospitalization. Higher age, unwitnessed arrest, non-shockable cardiac arrest rhythm, no sustained return of spontaneous circulation (ROSC) at the time of hospital admission, and resuscitation time on scene were most predictive of mortality (C-index, 0.82). Using the model β coefficients, we developed an integer risk score ranging from 0 to 10 points, corresponding to observed mortality rates of 5% to 100% (Figure 1). The odds of in-hospital mortality doubled for each 1-unit score increase (odds ratio, 2.01; 95% CI, 1.94-2.09; p<0.0001), and a score of ≥6, involving ~15% of patients, was associated with ≥85% in-hospital mortality risk. Conclusions: This risk score, based on simple prehospital characteristics, stratifies the range of in-hospital mortality from 5% to nearly 100% in OHCA patients with STEMI at the time of hospital presentation. The benefits of such a model in decision-making for immediate coronary angiography should be prospectively studied.

ST-elevation myocardial infarction complicated by cardiac arrest in a young patient with familiar dyslipidemia

2021 ◽  
Vol 148 (12) ◽  
pp. 141-145
Author(s):  
Pham Minh Tuan ◽  
Doan Tuan Vu
Keyword(s):  
Myocardial Infarction ◽  
Cardiac Arrest ◽  
Stem Cell ◽  
Cell Therapy ◽  
Young Patient ◽  
Stem Cell Therapy ◽  
St Elevation Myocardial Infarction ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
St Elevation

Coronary heart disease in young patients always poses great challenges for every healthcare system with differences in clinical manifestations, etiology, epidemiology, angiographic characteristics and prognosis. The objective of this study was to describe a case of ST-elevation myocardial infarction complicated by cardiac arrest in a young patient with familial dyslipidemia. A 30-year-old male visited our hospital with typical angina. During the examination, he suffered a sudden loss of consciousness, the monitor showed ventricular fibrillation. After successful resuscitation of cardiac arrest, electrocardiography showed apparent ST-elevation from V2 to V6 leads consistent with the diagnosis of anterolateral infarction. Emergency coronary angiogram showed severe three-vessel lesions including complete occlusion of the LAD artery and 80 - 90% stenosis of the other two coronary branches. Our patient’s coronary arteries were revascularized using drug-eluting stents in LAD artery and subsequently RCA artery, stem cell therapy was applied during the interventional process. Routine laboratory test results showed dyslipidemia and his family records suggested familiar (hereditary) dyslipidemia which affected his mother and sister. 1-month follow-up echocardiography showed a drastic improvement of LVEF by roughly 15%. The combination of revascularization, stem cell therapy, and lipid-lowering therapy has shown a good therapeutic effect.

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