• Shumpei Kosugi, Kazuya Shinouchi, Yasunori Ueda, Haruhiko Abe, Taku Sogabe, Kenichiro Ishida, Tsuyoshi Mishima, Tatsuhisa Ozaki, Kohtaro Takayasu, Yoshinori Iida, Takuya Ohashi, Chieko Toriyama, Masayuki Nakamura, Yasuhiro Ueda, Shun Sasaki, Mikiko Matsumura, Takashi Iehara, Motoo Date, Mitsuo Ohnishi, Masaaki Uematsu, and Yukihiro Koretsune.
• Cardiovascular Division, National Hospital Organization Osaka National Hospital, Osaka, Japan.
• J. Am. Coll. Cardiol. 2020 Oct 27; 76 (17): 1934-1943.

BackgroundSudden cardiac arrest is a serious complication of acute myocardial infarction (MI). Although in-hospital mortality from MI has decreased, the mortality of MI patients complicated with out-of-hospital cardiac arrest (OHCA) remains high. However, the features of acute MI patients with OHCA have not been well known.ObjectivesWe sought to characterize the clinical and angiographic features of acute MI patients with OHCA comparing with those without OHCA.MethodsWe retrospectively analyzed 480 consecutive patients with acute MI undergoing percutaneous coronary intervention. Patients complicated with OHCA were compared with patients without OHCA.ResultsOf the patients, 141 (29%) were complicated with OHCA. Multivariate analysis revealed that age (odds ratio [OR]: 0.8; 95% confidence interval [CI]: 0.7 to 0.9 per 5 years; p < 0.001), estimated glomerular filtration rate (OR: 0.8; 95% CI: 0.7 to 0.8 per 10 ml/min/1.73 m2; p < 0.001), peak creatine kinase-myocardial band (OR: 1.3; 95% CI: 1.2 to 1.4 per 102 U/l; p < 0.001), calcium-channel antagonists use (OR: 0.4; 95% CI: 0.2 to 0.7; p = 0.002), the culprit lesion at the left main coronary artery (OR: 5.3; 95% CI: 1.9 to 15.1; p = 0.002), and the presence of chronic total occlusion (OR: 2.9; 95% CI: 1.5 to 5.7; p = 0.001) were significantly associated with OHCA.ConclusionsYounger age, no use of calcium-channel antagonists, worse renal function, larger infarct size, culprit lesion in the left main coronary artery, and having chronic total occlusion were associated with OHCA.Copyright © 2020 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

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