Abstract 14821: Statin Use is Associated With Better Outcomes in Patients With Out-of-Hospital Cardiac Arrest in a Nationwide Cohort Study
Introduction: The post-cardiac arrest syndrome is associated with activation of inflammatory reactions and oxidative stress. The statins have pleotropic effects of attenuation damage from inflammatory reactions and endothelial dysfunction against ischemia-reperfusion.
Hypothesis: The statin use prior to cardiac arrest might improve outcomes of out-of-hospital cardiac arrest (OHCA) patients.
Methods: A nationwide OHCA cohort, from 01/01/2004 to 12/31/2011, was identified by Taiwan national health insurance research database (NHIRD). Patients are included if 1) resuscitation performed in ED, 2) age>=18 year old, 3) stay in ED less then 6 hours, 4) no trauma-related diagnosis, 5) triage level one. Those patients were divided into 2 groups according to statin use prior to cardiac arrest. The patients with any statin for at least 90 days in the previous year of cardiac arrest are divided into statin group, and those had no statin use are non-statin group. Those patients were matched by propensity-score to reduce the influence of outcomes by pre-arrest factors. Outcomes including survival to admission, survival to discharge and one-year survival were analyzed. The subgroup analysis was applied to identify the possible mechanism on cardiac arrest by statin.
Results: Total 137933 OHCA patients were identified for the final analysis, among them 9059 patients in statin group. After propensity matched, there were 8249 patients in statin group and 24747 in non-statin group. The odds ratio (OR) of survival to admission, discharge and one-year were 1.19 (95% CI: 1.12~1.27), 1.47 (95% CI: 1.31~1.65), and 1.50 (95% CI: 1.31~1.71) respectively. The logistic regression model revealed statin was associated with improved one-year survival independently, the odds ratio 1.45 (95% CI: 1.26~1.68). In subgroup analysis, patients with diabetes mellitus DM are significantly benefitted with statin use.
Conclusions: Statin use prior to cardiac arrest is associated with improved outcomes, including survival to ICU admission, survival to hospital discharge and survival to 1-year. Those with diabetes mellitus are especially improved
Author Disclosures: P. Yu: None. C. Huang: None. M. Tsai: None. W. Chen: None.
- © 2016 by American Heart Association, Inc.