scholarly journals Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: A registry database study

2014 ◽  
Vol 4 (1) ◽  
pp. 6-15 ◽  
Author(s):  
Vijay Kunadian ◽  
Bilal Bawamia ◽  
Annette Maznyczka ◽  
Azfar Zaman ◽  
Weiliang Qiu
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Cardiac Arrest ◽  
Hospital Mortality ◽  
Primary Percutaneous Coronary Intervention ◽  
Multiple Logistic Regression Analysis ◽  
Female Gender ◽  
Coronary Intervention ◽  
Percutaneous Coronary ◽  
Cardiac Centre ◽  
St Elevation

Background: The mortality rate among patients undergoing primary percutaneous coronary intervention (PPCI) in the setting of cardiac arrest (CA) and whether the location where the patient sustains CA influences the outcome is not known in the contemporary era. Methods: Prospectively collected data at a tertiary cardiac centre on all patients undergoing PPCI for ST elevation myocardial infarction (STEMI) in the setting of CA was analysed. Results: In total, 484/4118 (11.8%) patients sustained CA during the study period. Of these, 91/484 (18.8%) sustained CA prior to ambulance arrival, the remainder occurred either after ambulance arrival or in hospital. The overall in-hospital mortality was 20.5% in this cohort. Those sustaining CA before ambulance arrival experienced the highest unadjusted mortality compared to those that had CA after ambulance arrival, in hospital and in the catheterisation laboratory (29.7% versus 12.0%, 16.1% and 23.8% respectively, p=0.03). Multiple logistic regression analysis showed that the following parameters are independent predictors of in-hospital mortality: age (odds ratio (OR) for each year increment of age 1.05; 95% confidence interval (CI) 1.02–1.08, p=0.0009); female gender (OR 2.42; 95% CI 1.17–4.99, p=0.0173); previous PCI (OR 7.59; 95% CI 1.72–33.53, p=0.0075); asystole/ electromechanical dissociation (EMD) (OR 13.43; 95% CI 5.34–33.80, p<0.0001); and patient location at arrest (OR 5.77 for before ambulance arrival; 95% CI 2.55–13.07, p<0.0001). Conclusions: In conclusion, in-hospital mortality remains high among patients undergoing PPCI in the context of CA, particularly among those that arrest prior to ambulance arrival.

scholarly journals The effects of prearrival direct notification call to interventional cardiologist on door-to-balloon time in patients who required secondary diversion with ST-elevation myocardial infarction for primary percutaneous coronary intervention

2018 ◽  
Vol 26 (3) ◽  
pp. 165-173
Author(s):  
Jeong Cheon Choe ◽  
Kwang Soo Cha ◽  
Jin Hee Choi ◽  
Jinhee Ahn ◽  
Jin Hee Kim ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Hospital Mortality ◽  
Primary Percutaneous Coronary Intervention ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Catheterization Laboratory ◽  
Percutaneous Coronary ◽  
St Elevation ◽  
Door To Balloon

Background: Rapid door-to-balloon times in ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention are associated with favorable outcomes. Objectives: We evaluated the effects of prearrival direct notification calls to interventional cardiologists on door-to-balloon time for ST-elevation myocardial infarction patients undergoing primary percutaneous coronary intervention. Methods: A 24-h hotline was created to allow prearrival direct notification calls to interventional cardiologists when transferring ST-elevation myocardial infarction patients. In an urban, tertiary referral center, patients who visited via inter-facility or the emergency department directly were included. Clinical parameters, time to reperfusion therapy, and in-hospital mortality were compared between patients with and without prearrival notifications. Results: Of 228 ST-elevation myocardial infarction patients, 95 (41.7%) were transferred with prearrival notifications. In these patients, door-to-balloon time was shorter (50.0 vs 60.0 min, p = 0.010) and the proportion of patients with door-to-balloon time < 90 min was higher (89.5% vs 75.9%, p = 0.034) than patients without notifications. These improvements were more pronounced during “off-duty” hours (52.0 vs 78.0 min, p = 0.001; 88.3% vs 72.3%, p = 0.047, respectively) than during “on-duty” hours (37.5 vs 43.5 min, p = 0.164; 94.4% vs 79.4%, p = 0.274, respectively). In addition, door-to-activation time (–39 vs 11 min, p < 0.001) and door-to-catheterization laboratory arrival time (33 vs 42 min, p = 0.007) were shorter in patients with prearrival notifications than those without. However, in-hospital mortality was similar between the two groups (6.3% vs 6.8%, p = 0.892). Conclusion: Prearrival direct notification calls to interventional cardiologists significantly improved the door-to-balloon time and the proportion of patients with door-to-balloon time < 90 min through rapid patient transport in primary percutaneous coronary intervention scheduled hospital and readiness of the catheterization laboratory.

The Predictive Value of PRECISE-DAPT Score for In-Hospital Mortality in Patients With ST-Elevation Myocardial Infarction Undergoing Primary Percutaneous Coronary Intervention

Angiology ◽  
2018 ◽  
Vol 70 (5) ◽  
pp. 440-447 ◽  
Author(s):  
Veysel Ozan Tanik ◽  
Tufan Cinar ◽  
Emre Arugaslan ◽  
Yavuz Karabag ◽  
Mert Ilker Hayiroglu ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Hospital Mortality ◽  
Primary Percutaneous Coronary Intervention ◽  
Predictive Value ◽  
Coronary Intervention ◽  
St Elevation Myocardial Infarction ◽  
Bleeding Complications ◽  
Percutaneous Coronary ◽  
St Elevation

The PREdicting bleeding Complications In patients undergoing Stent implantation and subsEquent Dual Anti-Platelet Therapy (PRECISE-DAPT) score predicts the bleeding risk in patients treated with dual antiplatelet treatment after primary percutaneous coronary intervention (pPCI). This study aimed to determine the predictive value of the admission PRECISE-DAPT score for in-hospital mortality in patients with ST elevation myocardial infarction (STEMI) treated with pPCI. Of the 1418 patients enrolled, the study population was divided into 2 groups: PRECISE-DAPT score ≥25 and PRECISE-DAPT score <25. The primary goal was to determine the incidence of in-hospital all-cause mortality. In-hospital mortality was significantly higher in patients whose PRECISE-DAPT score ≥25 compared with the patients whose PRECISE-DAPT score <25 (9.4 vs 0.9%; P < .001, respectively). Both univariate and multivariate Cox proportional hazard analyses showed that the PRECISE-DAPT score is independently associated with in-hospital mortality (hazards ratio [HR]: 1.043, 95% confidence interval [CI]: 1.003-1.084; P = .035; and HR: 1.026, 95% CI: 1.004-1.048; P = .021, respectively). A pairwise comparison of receiver operating characteristic curves showed that the predictive value of the PRECISE-DAPT score with regard to in-hospital mortality was noninferior compared with the Thrombolysis in Myocardial Infarction risk score. The PRECISE-DAPT score may be a significant independent predictor of in-hospital mortality in patients with STEMI treated with pPCI.

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