Background: Early reperfusion by direct percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarctions (STEMI) with an out-of-hospital cardiac arrest (OHCA) reduces hospital and longterm mortality. Aims: Evaluating the significance of direct PCI for the short-term (discharge from acute hospitalization) and 1-year survival in patients with acute STEMI after OHCA. Methods: In this prospective study, from April 1, 2002 up to August 31, 2004, a total of 26 hospitalized individuals (22 men, 4 women, aged 35–79 years, median 58.5) from the East Bohemian region with OHCA (primary group of 718 individuals) with acute STEMI were included. Urgent coronary angiography was performed in 20 individuals, and direct PCI was done in 19 of them. The remaining 6 patients did not undergo angiography. Results: Fifteen patients (57.7%) survived acute hospitalization, of whom 11 were without neurological deficits. In the subgroup with urgent coronary angiography 14 patients (70%) survived hospitalization, and in the subgroup without coronarography only 1 patient survived hospitalization (16.7%). In the subgroup with PCIs, 13 out of the 19 patients survived (68.4%). None of the patients died during the 1-year follow-up after being discharged from acute hospitalization. According to the urgent coronarography the artery most commonly responsible for the infarction was the left anterior descending artery (50%). Initial TIMI flow grade 0–I was found in 17 patients and grade II–III in 3 individuals. After PCI, irrespective of stent implantation, an optimal angiographic success (TIMI flow grade II–III) was obtained in 17 cases. Conclusion: Short-term survival of patients after OHCA with STEMI treated with direct PCI was found to be 68.4%. Out of 6 patients not receiving reperfusion therapy 1 survived (16.7%). Over the course of the 1-year follow-up none of the patients died.

1.
Van de Werf F, Ardissino D, Betriu A, Cokkinos DV, Falk E, Fox KA, Julian D, Lengyel M, Neumann FJ, Ruzyllo W, Thygesen C, Underwood SR, Vahanian A, Verheugt FW, Wijns W; Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology: Management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J 2003;24:28–66.
2.
Sayer JW, Archbold RA, Wilkinson P, Ray S, Ranjadayalan K, Timmis AD: Prognostic implications of ventricular fibrillation in acute myocardial infarction: new strategies required for further mortality reduction. Heart 2000;84:258–261.
3.
Antman EM, Anbe DT, Armstrong PW, Bates ER, Green LA, Hand M, Hochman JS, Krumholz HM, Kushner FG, Lamas GA, Mullany CJ, Ornato JP, Pearle DL, Sloan MA, Smith SC Jr, Alpert JS, Anderson JL, Faxon DP, Fuster V, Gibbons RJ, Gregoratos G, Halperin JL, Hiratzka LF, Hunt SA, Jacobs AK, Ornato JP: ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction; a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee to Revise the 1999 Guidelines for the Management of patients with acute myocardial infarction). J Am Coll Cardiol 2004;44:E1–E211.
4.
Engdahl J, Holmberg M, Karlson BW, Luepker R, Herlitz J: The epidemiology of out-of-hospital ‘sudden’ cardiac arrest. Resuscitation 2002;52:235–245.
5.
van Campen LC, van Leeuwen GR, Verheugt FW: Safety and efficacy of thrombolysis for acute myocardial infarction in patients with prolonged out-of-hospital cardiopulmonary resuscitation. Am J Cardiol 1994;73:953–955.
6.
Grines CL, Browne KF, Marco J, Rothbaum D, Stone GW, O’Keefe J, Overlie P, Donohue B, Chelliah N, Timmis GC, et al: A comparison of immediate angioplasty with thrombolytic therapy for acute myocardial infarction. The Primary Angioplasty in Myocardial Infarction Study Group. N Engl J Med 1993;328:673–679.
7.
Bendz B, Eritsland J, Nakstad AR, Brekke M, Klow NE, Steen PA, Mangschau A: Long-term prognosis after out-of-hospital cardiac arrest and primary percutaneous coronary intervention. Resuscitation 2004;63:49–53.
8.
Kahn JK, Glazier S, Swor R, Savas V, O’Neill WW: Primary coronary angioplasty for acute myocardial infarction complicated by out-of-hospital cardiac arrest. Am J Cardiol 1995;75:1069–1070.
9.
Bulut S, Aengevaeren WR, Luijten HJ, Verheugt FW: Successful out-of-hospital cardiopulmonary resuscitation: what is the optimal in-hospital treatment strategy? Resuscitation 2000;47:155–161.
10.
Keelan PC, Bunch TJ, White RD, Packer DL, Holmes DR Jr: Early direct coronary angioplasty in survivors of out-of-hospital cardiac arrest. Am J Cardiol 2003;91:1461–1463.
11.
Lee CH, Lemos PA, Degertekin M, Saia F, Tanabe K, Serruys PW: In-hospital versus out-of-hospital cardiac arrest complicating myocardial infarction: survival after percutaneous coronary revascularization. Int J Cardiol 2005;98:359–360.
12.
Spaulding CM, Joly LM, Rosenberg A, Monchi M, Weber SN, Dhainaut JF, Carli P: Immediate coronary angiography in survivors of out-of-hospital cardiac arrest. N Engl J Med 1997;336:1629–1633.
13.
Jacobs I, Nadkarni V, Bahr J, Berg RA, Billi JE, Bossaert L, Cassan P, Coovadia A, D’Este K, Finn J, Halperin H, Handley A, Herlitz J, Hickey R, Idris A, Kloeck W, Larkin GL, Mancini ME, Mason P, Mears G, Monsieurs K, Montgomery W, Morley P, Nichol G, Nolan J, Okada K, Perlman J, Shuster M, Steen PA, Sterz F, Tibballs J, Timerman S, Truitt T, Zideman D: Cardiac arrest and cardiopulmonary resuscitation outcome reports: update and simplification of the Utstein templates for resuscitation registries: a statement for healthcare professionals from a task force of the International Liaison Committee on Resuscitation. Circulation 2004;110:3385–3397.
14.
Cummins RO, Chamberlain DA, Abramson NS, Allen M, Baskett P, Becker L, Bossaert L, Delooz H, Dick W, Eisenberg M, et al: Recommended guidelines for uniform reporting of data from out-of-hospital cardiac arrest: the Utstein Style. Task Force of the American Heart Association, the European Resuscitation Council, the Heart and Stroke Foundation of Canada, and the Australian Resuscitation Council. Ann Emerg Med 1991;20:861–874.
15.
Pleskot M, Babu A, Kajzr J, Kvasnicka J, Stritecky J, Cermakova E, Mestan M, Parizek P, Tauchman M, Tusl Z, Perna P: Characteristics and short-term survival of individuals with out-of-hospital cardiac arrests in the East Bohemian region. Resuscitation 2006;68:209–220.
16.
Teasdale G, Jennett B: Assessment of coma and impaired consciousness. A practical scale. Lancet 1974;ii:81–84.
17.
Brain Resuscitation Clinical Trial I Study Group: A randomized clinical study of cardiopulmonary-cerebral resuscitation: design, methods, and patient characteristics. Am J Emerg Med 1986;4:72–86.
18.
Gibson CM, Cannon CP, Daley WL, Dodge JT Jr, Alexander B Jr, Marble SJ, McCabe CH, Raymond L, Fortin T, Poole WK, Braunwald E: TIMI frame count: a quantitative method of assessing coronary artery flow. Circulation 1996;93:879–888.
19.
Borger van der Burg AE, Bax JJ, Boersma E, Bootsma M, van Erven L, van der Wall EE, Schalij MJ: Impact of percutaneous coronary intervention or coronary artery bypass grafting on outcome after nonfatal cardiac arrest outside the hospital. Am J Cardiol 2003;91:785–789.
20.
Popma JJ: Coronary angiography and intravascular ultrasound imaging; in Braunwald E (ed): Heart Disease. A Textbook of Cardiovascular Medicine, ed 7 (revised). Philadelphia, Saunders, 2005, pp 423–455.
21.
Priori SG, Aliot E, Blomstrom-Lundqvist C, Bossaert L, Breithardt G, Brugada P, Camm JA, Cappato R, Cobbe SM, Di MC, Maron BJ, McKenna WJ, Pedersen AK, Ravens U, Schwartz PJ, Trusz-Gluza M, Vardas P, Wellens HJ, Zipes DP: Task Force on Sudden Cardiac Death, European Society of Cardiology. Europace 2002;4:3–18.
22.
Myerburg RJ, Castellanos A: Cardiac arrest and sudden cardiac death; in Braunwald E (ed): Heart Disease. A Textbook of Cardiovascular Medicine, ed 7 (revised). Philadelphia, Saunders, 2005, pp 865–908.
23.
Kannel WB, Thomas HE Jr: Sudden coronary death: the Framingham Study. Ann NY Acad Sci 1982;382:3–21.
24.
Kagan AR, Uemura K: Atherosclerosis of the aorta and coronary arteries in five towns. Bull World Health Organ 1976;53:489–499.
25.
Davies MJ, Thomas A: Thrombosis and acute coronary-artery lesions in sudden cardiac ischemic death. N Engl J Med 1984;310:1137–1140.
26.
Rudner R, Jalowiecki P, Karpel E, Dziurzik P, Alberski B, Kawecki P: Survival after out-of-hospital cardiac arrests in Katowice (Poland): outcome report according to the ‘Utstein style’. Resuscitation 2004;61:315–325.
27.
Layon AJ, Gabrielli A, Goldfeder BW, Hevia A, Idris AH: Utstein style analysis of rural out-of-hospital cardiac arrest (OOHCA): total cardiopulmonary resuscitation (CPR) time inversely correlates with hospital discharge rate. Resuscitation 2003;56:59–66.
28.
Finn JC, Jacobs IG, Holman CD, Oxer HF: Outcomes of out-of-hospital cardiac arrest patients in Perth, Western Australia, 1996–1999. Resuscitation 2001;51:247–255.
29.
Eng Hock Ong M, Chan YH, Anantharaman V, Lau ST, Lim SH, Seldrup J: Cardiac arrest and resuscitation epidemiology in Singapore (CARE I Study). Prehosp Emerg Care 2003;7:427–433.
Copyright / Drug Dosage / Disclaimer
Copyright: All rights reserved. No part of this publication may be translated into other languages, reproduced or utilized in any form or by any means, electronic or mechanical, including photocopying, recording, microcopying, or by any information storage and retrieval system, without permission in writing from the publisher.
Drug Dosage: The authors and the publisher have exerted every effort to ensure that drug selection and dosage set forth in this text are in accord with current recommendations and practice at the time of publication. However, in view of ongoing research, changes in government regulations, and the constant flow of information relating to drug therapy and drug reactions, the reader is urged to check the package insert for each drug for any changes in indications and dosage and for added warnings and precautions. This is particularly important when the recommended agent is a new and/or infrequently employed drug.
Disclaimer: The statements, opinions and data contained in this publication are solely those of the individual authors and contributors and not of the publishers and the editor(s). The appearance of advertisements or/and product references in the publication is not a warranty, endorsement, or approval of the products or services advertised or of their effectiveness, quality or safety. The publisher and the editor(s) disclaim responsibility for any injury to persons or property resulting from any ideas, methods, instructions or products referred to in the content or advertisements.
You do not currently have access to this content.