Circulation, Vol 64, 977-984, Copyright © 1981 by American Heart Association
S Goldstein, JR Landis, R Leighton, G Ritter, CM Vasu, A Lantis and R Serokman
The clinical entry characteristics and medical history of 142 resuscitated
out-of-hospital cardiac arrest victims with coronary heart disease were
studied in order to identify factors that affect their long-term survival.
The cardiac arrest event was classified as being secondary to an acute
myocardial infarction (AMI) in 44% (62 of 142), an ischemic event (IE) in
34% (49 of 142) and a primary arrhythmic event (PAE) in 22% (31 of 142).
The majority of patients in all groups had a history of angina pectoris.
Twenty-seven percent of the AMI, 55% of the IE, and 71% of the PAE patients
had a history of infarction. Ten percent of the AMI, 31% of the IE, and 55%
of the PAE had used digitalis before their cardiac arrest. Cardiac arrest
was the first cardiac event in 35% of the AMI, 16% of the IE and 6% of the
PAE patients. One year after arrest, 89% of the AMI, 80% of the IE and 71%
of the PAE were alive (p less than 0.01). Covariate analysis for more than
40 variables indicates that a high-risk group included 22% (31 of 142) of
the cardiac arrest victims had 1- and 2-year survival rates of 71% and 55%,
respectively, and was characterized as having used digitalis before arrest,
experiencing blood urea nitrogen elevation and pulmonary congestion during
the hospitalization for the event, and classification of the cardiac arrest
event as a PAE. A low-risk group comprised 78% (111 of 142) of the
survivors and had 1- and 2-year survival rates of 85% and 69%,
respectively. These data indicate that cardiac arrest due to coronary heart
disease is secondary to several mechanisms related to subsequent survival.
ARTICLES
Characteristics of the resuscitated out-of-hospital cardiac arrest victim with coronary heart disease
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