Kvakkestad KM, et al. - This study was performed to assess the relative short- and long-term survival in patients admitted to hospital after acute myocardial infarction (AMI) with and without out-of-hospital cardiac arrest (OHCA). They observed good long-term survival after OHCA due to AMI, with 49% of admitted patients being alive after eight years. Despite high short-term mortality, OHCA patients alive after 30 days had similar long-term risk as AMI patients without OHCA.

Methods

• Researchers performed prospective cohort study of all AMI patients admitted to Oslo University Hospital Ulleval from September 1, 2005 to December 31, 2011.
• They obtained all-cause mortality from the Norwegian Cause of Death Registry with censoring date December 31, 2013.
• With the Kaplan-Meier and the Life-table method, they determined cumulative survival.
• For risk comparisons, Logistic- and Cox regression were used.

Results

• Four hundred and four AMI patients with OHCA and 9,425 AMI patients without were identified.
• Researchers stratified AMI patients without OHCA as ST-elevation myocardial infarction (STEMI, n = 4,522) or non-STEMI (NSTEMI, n = 4903).
• In OHCA, STEMI and NSTEMI, mean age was 63.6 ± standard deviation (SD) 12.5, 63.8 ± 13.1 and 69.7 ± 13.6 years, respectively.
• In 87% of OHCA, they performed coronary angiography with subsequent percutaneous coronary intervention, if indicated; 97% of STEMI and 80% of NSTEMI patients underwent the procedure.
• For OHCA, STEMI and NSTEMI, 30 survival was 63%, 94% and 94%, and 8-year survival was 49%, 74%, and 57%, respectively.
• They observed no significant difference in risk during long-term follow-up (adjusted Hazard Ratio (aHR)_OHCAvsSTEMI 1.15 [95% CI 0.82–1.60], aHR_OHCAvsNSTEMI 0.89 [95% CI 0.64-1.24]) among patients surviving the first 30 days.