Abstract 11181: Presentation With Cardiac Arrest in Patients With Acute Coronary Syndromes: Insights From the Second Gulf Registry of Acute Coronary Events
OBJECTIVES: There is very scarce contemporary data about the prognostic impact of presentation with cardiac arrest in patients with acute coronary syndromes (ACS), particularly from the developing countries. Accordingly, we sought to assess the incidence, clinical features, immediate and long term mortality of patients with cardiac arrest at presentation using data from a large multicenter Middle-Eastern ACS registry.
METHODS: For a period of 9 months in 2008 to 2009, consecutive patients with ACS were enrolled from 65 hospitals in 6 Middle East countries. Patients presenting with cardiac arrest in this cohort were selected and in-hospital outcomes, one-month and one-year mortality were examined.
RESULTS: Among 7,930 ACS patients enrolled, there were 89 patients hospitalized alive after resuscitation from cardiac arrest with a rate of 1.1%. Compared with patients without cardiac arrest, patients presenting with cardiac arrest had a significantly higher rate of prior myocardial infarction (32.6% vs. 19.6%), a higher serum creatinine (mean 155 vs. 102 mmol/L), a lower rate of diabetes mellitus (27.3% vs. 40.3%) and prolonged length of hospital stay (mean 8.8 vs. 6 days) [table]. Presentation with cardiac arrest was associated with increased risk of in-hospital (40.4% vs. 4.2%), one-month (45.3% vs. 7.7%), and one-year mortality (51.9% vs. 12.1%), (all P<0.001). Presentation with cardiac arrest was an independent predictor of in-hospital, one-month and one-year mortality (OR 15.8, 95% CI= 5.6-14.7, OR 9.15, 95% CI= 5.6-14.7, and OR 7.6, 95% CI= 4.6-12.4, respectively, all P<0.001).
CONCLUSIONS: ACS patients presenting with cardiac arrest continue to have higher in-hospital and long term mortality. Better utilization of evidence-based therapies and interventions in these high risk patients may translate into improved outcomes.
Author Disclosures: A.M. Salam: None. K.F. AlHabib: None. W. Almahmeed: None. A. Alsheikh-Ali: Other Research Support; Modest; Medtronic, Behringer Ingelheim. Honoraria; Modest; Boehringer Ingelheim, Bayer, Pfizer. K. Sulaiman: None. H. Amin: None. J. Al-Lawati: None. A. Al-Motarreb: None. N. Asaad: None. R. Singh: None. J. Al Suwaidi: None.
- © 2014 by American Heart Association, Inc.