Abstract P190: Aetiology of Cardiac Arrest Predicts Outcome in Patients Treated with Mild Therapeutic Hypothermia
Background: Mild therapeutic hypothermia (MTH) has been implemented into the international resuscitation guidelines. More than 50% of patients treated with MTH had cardiac arrest secondary to myocardial ischemia as shown by our recent nationwide survey in Germany. However, it has not yet been investigated whether such aetiology of cardiac arrest affects outcome in patients treated with MTH.
Methods: 74 consecutive patients after cardiac arrest admitted to our ICU between 2005 and 2007 were treated with MTH in addition to standard therapy. Mortality after 6 months as well as the neurological outcome was documented using the Glasgow Pittsburgh Cerebral Performance Scale (GPCP). STEMI and NSTEMI were diagnosed according to AHA/ACC recommendations.
Results (table⇓): Cooling modalities did not differe between the groups. The rate of successful revascularisation was significantly lower in patients with cardiac arrest due to NSTEMI as compared to those with STEMI. Mortality was significantly higher in patients with NSTEMI than in STEMI patients. Patients without evidence for acute myocardial infarction were at intermediate risk. Long-term neurological outcome is excellent in survivors of cardiac arrest independent on the aetiology of cardiac arrest.
Conclusions: Further studies are necessary to evaluate new treatment strategies to reduce excess mortality in patients with NSTEMI.