• Eva M Spoormans, Jorrit S Lemkes, Gladys N Janssens, Nina W van der Hoeven, Jewbali Lucia S D LSD Thorax Centre, Erasmus Medical Centre, Rotterdam, the Netherlands., Eric A Dubois, Peter M van de Ven, Martijn Meuwissen, Tom A Rijpstra, Hans A Bosker, Michiel J Blans, Gabe B Bleeker, Remon Baak, Georgios J Vlachojannis, Eikemans Bob J W BJW Department of Intensive care medicine, Maasstad Hospital, Rotterdam, the Netherlands., der Harst Pim van PV University of Groningen, University Medical Centre Groningen, Department of Cardiology, Groningen, the Netherlands; Department of Cardiology, Univers, van der Horst Iwan C C ICC University of Groningen, University Medical Centre Groningen, Department of Intensive care medicine, Groningen, the Netherlands; Department of , Michiel Voskuil, Joris J van der Heijden, Albertus Beishuizen, Martin Stoel, Cyril Camaro, Hans van der Hoeven, José P Henriques, Vlaar Alexander P J APJ Department of Intensive care medicine, Amsterdam University Medical Centre, location AMC, Amsterdam, the Netherlands., Maarten A Vink, Bas van den Bogaard, Ton A C M Heestermans, Wouter de Ruijter, Delnoij Thijs S R TSR Department of Intensive care medicine, Maastricht University Medical Centre, University Maastricht, Maastricht, the Netherlands., Crijns Harry J G M HJGM Department of Cardiology, Maastricht University Medical Centre, Maastricht, the Netherlands., Jessurun Gillian A J GAJ Department of Cardiology, Scheper Hospital, Emmen, the Netherlands., Pranobe V Oemrawsingh, Marcel T M Gosselink, Koos Plomp, Michael Magro, Elbers Paul W G PWG Department of Intensive care medicine, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands., Yolande Appelman, and Niels van Royen.
• Department of Cardiology, Amsterdam University Medical Centre, location VUmc, Amsterdam, the Netherlands.
• Resuscitation. 2021 Jan 1; 158: 14-22.

BackgroundWhether sex is associated with outcomes of out-of-hospital cardiac arrest (OHCA) is unclear.ObjectivesThis study examined sex differences in survival in patients with OHCA without ST-segment elevation myocardial infarction (STEMI).MethodsUsing data from the randomized controlled Coronary Angiography after Cardiac Arrest (COACT) trial, the primary point of interest was sex differences in OHCA-related one-year survival. Secondary points of interest included the benefit of immediate coronary angiography compared to delayed angiography until after neurologic recovery, angiographic and clinical outcomes.ResultsIn total, 522 patients (79.1% men) were included. Overall one-year survival was 59.6% in women and 63.4% in men (HR 1.18; 95% CI: 0.76-1.81;p = 0.47). No cardiovascular risk factors were found that modified survival. Women less often had significant coronary artery disease (CAD) (37.0% vs. 71.3%;p < 0.001), but when present, they had a worse prognosis than women without CAD (HR 3.06; 95% CI 1.31-7.19;p = 0.01). This was not the case for men (HR 1.05; 95% CI 0.67-1.65;p = 0.83). In both sexes, immediate coronary angiography did not improve one-year survival compared to delayed angiography (women, odds ratio (OR) 0.87; 95% CI 0.58-1.30;p = 0.49; vs. men, OR 0.97; 95% CI 0.45-2.09;p = 0.93).ConclusionIn OHCA patients without STEMI, we found no sex differences in overall one-year survival. Women less often had significant CAD, but when CAD was present they had worse survival than women without CAD. This was not the case for men. Both sexes did not benefit from a strategy of immediate coronary angiography as compared to delayed strategy with respect to one-year survival.Clinical Trial Registration NumberNetherlands trial register (NTR) 4973.Copyright © 2020. Published by Elsevier B.V.

14 keywords...

hide…