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dc.contributor.authorChoudry, FAen_US
dc.contributor.authorWeerackody, RPen_US
dc.contributor.authorTimmis, ADen_US
dc.contributor.authorWragg, Aen_US
dc.contributor.authorMathur, Aen_US
dc.contributor.authorSporton, Sen_US
dc.contributor.authorMills, PGen_US
dc.contributor.authorJain, AKen_US
dc.date.accessioned2015-12-15T10:57:15Z
dc.date.available2014-09-29en_US
dc.date.issued2015-08en_US
dc.identifier.urihttp://qmro.qmul.ac.uk/xmlui/handle/123456789/9815
dc.description.abstractBACKGROUND: Current recommendations are for primary percutaneous coronary intervention (pPCI) in ST-elevation myocardial infarction (STEMI) complicated by out of hospital cardiac arrest (OHCA). However, information about longer-term outcomes is sparse, particularly among high-risk patients who do not regain consciousness promptly after resuscitation. METHODS AND RESULTS: Of 1836 consecutive patients admitted with STEMI for pPCI between April 2008-October 2011, 132 (7.2%) who had suffered OHCA with recovery of spontaneous circulation (ROSC) form the study population. 101 patients survived to hospital discharge (76.5%) with only one further death in the first year. Prognosis was worse for the 62 patients who were unconscious on arrival and required admission to the intensive therapy unit (ITU), only 54% of whom survived. Every additional minute in the time to ROSC increased the hazard of death by 1.7% while alertness upon ROSC and successful reperfusion in response to pPCI reduced the hazard of death by 90% and 65% respectively. Full neurological recovery was recorded in 85.1% of those who survived to be discharged but in only 30.6% of the 34 survivors who were admitted unconscious and received ITU treatment. Every additional minute in the time to ROSC increased the odds of neurological deficit by 7.0%. CONCLUSIONS: In patients with STEMI who are conscious after OHCA, high rates of survival can be achieved with pPCI, depending in part on the time it takes for ROSC. Prognosis is less good in the subgroup brought to hospital unconscious but even in this high risk group neurologically intact survival can be achieved in about one-third of cases, suggesting the benefit of immediate pPCI in STEMI patients successfully resuscitated after OHCA.en_US
dc.format.extent378 - 385en_US
dc.languageengen_US
dc.language.isoenen_US
dc.relation.ispartofEur Heart J Acute Cardiovasc Careen_US
dc.rightshttp://acc.sagepub.com/content/4/4/378.abstract
dc.subjectST-elevation myocardial infarctionen_US
dc.subjectout of hospital cardiac arresten_US
dc.subjectprimary percutaneous coronary interventionen_US
dc.subjectAgeden_US
dc.subjectCardiopulmonary Resuscitationen_US
dc.subjectFemaleen_US
dc.subjectHumansen_US
dc.subjectMaleen_US
dc.subjectMiddle Ageden_US
dc.subjectOut-of-Hospital Cardiac Arresten_US
dc.subjectPercutaneous Coronary Interventionen_US
dc.subjectPrognosisen_US
dc.subjectRecovery of Functionen_US
dc.subjectRegistriesen_US
dc.subjectRisk Factorsen_US
dc.subjectST Elevation Myocardial Infarctionen_US
dc.subjectSurvival Analysisen_US
dc.subjectTime-to-Treatmenten_US
dc.subjectTreatment Outcomeen_US
dc.subjectUnconsciousnessen_US
dc.titleImportance of primary percutaneous coronary intervention for reducing mortality in ST-elevation myocardial infarction complicated by out of hospital cardiac arrest.en_US
dc.typeArticle
dc.identifier.doi10.1177/2048872614555990en_US
pubs.author-urlhttps://www.ncbi.nlm.nih.gov/pubmed/25326470en_US
pubs.issue4en_US
pubs.notesNot knownen_US
pubs.publication-statusPublisheden_US
pubs.volume4en_US
dcterms.dateAccepted2014-09-29en_US


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