• Qin Li, Shaun G Goodman, Raymond T Yan, Joel M Gore, Petr Polasek, Kevin Lai, Carolyn Baer, Robert J Goldberg, Arnold Pinter, Kamran Ahmad, Jan M Kornder, Andrew T Yan, and Global Registry of Acute Coronary Events and the Canadian Registry of Acute Coronary Events Investigators.
• Terrence Donnelly Heart Centre, St. Michael's Hospital, Toronto, Ont., Canada.
• Cardiology. 2013 Jan 1;126(1):27-34.

ObjectivesCardiac arrest in acute coronary syndromes (ACS) is associated with high morbidity and mortality. We examined the clinical characteristics, contemporary management patterns and outcomes of ACS patients with pre-hospital cardiac arrest.MethodsThe Global Registry of Acute Coronary Events and the Canadian Registry of Acute Coronary Events enrolled 14,010 ACS patients in 1999-2008. We compared the clinical characteristics, in-hospital treatment and outcomes between patients with and without pre-hospital cardiac arrest.ResultsOverall, 206 (1.4%) patients had cardiac arrest prior to hospital presentation. ACS patients with pre-hospital cardiac arrest were less frequently treated with aspirin, β-blocker, angiotensin-converting enzyme inhibitors, and statins within the first 24 h of presentation, but the use of cardiac procedures was similar compared to the group without cardiac arrest. Patients with pre-hospital cardiac arrest had significantly higher rates of in-hospital adverse events. Factors independently associated with pre-hospital cardiac arrest included male gender, current smoker status, tachycardia, higher Killip class and ST-segment deviation.ConclusionACS patients with pre-hospital cardiac arrest continue to have more in-hospital complications and higher mortality. Their use of evidence-based medical therapies was lower but the use of cardiac procedures was similar compared to the group without cardiac arrest. Better utilization of evidence-based therapies in these patients may translate into improved outcomes.Copyright © 2013 S. Karger AG, Basel.

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