Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest
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Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest. / Lauridsen, Marie D.; Josiassen, Jakob; Schmidt, Morten; Butt, Jawad H.; Østergaard, Lauge; Schou, Morten; Kjærgaard, Jesper; Møller, Jacob E.; Hassager, Christian; Torp-Pedersen, Christian; Gislason, Gunnar; Køber, Lars; Fosbøl, Emil L.
I: Resuscitation, Bind 162, 2021, s. 135-142.Publikation: Bidrag til tidsskrift › Tidsskriftartikel › Forskning › fagfællebedømt
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TY - JOUR
T1 - Prognosis of myocardial infarction-related cardiogenic shock according to preadmission out-of-hospital cardiac arrest
AU - Lauridsen, Marie D.
AU - Josiassen, Jakob
AU - Schmidt, Morten
AU - Butt, Jawad H.
AU - Østergaard, Lauge
AU - Schou, Morten
AU - Kjærgaard, Jesper
AU - Møller, Jacob E.
AU - Hassager, Christian
AU - Torp-Pedersen, Christian
AU - Gislason, Gunnar
AU - Køber, Lars
AU - Fosbøl, Emil L.
PY - 2021
Y1 - 2021
N2 - Aims: Out-of-hospital cardiac arrest (OHCA) is highly prevalent among patients with myocardial infarction and cardiogenic shock (MI-CS). We aimed to examine the prognostic importance of OHCA in patients with MI-CS. Methods: Using Danish nationwide registries, we identified first-time hospitalized MI-CS patients (2010–2015) by OHCA status. Cumulative incidence curves and adjusted Cox regression models were used to compare in-hospital mortality, and among hospital survivors we compared 5-year rates of heart failure hospitalization and mortality. Results: We identified 3107 MI-CS patients of whom 979 presented with OHCA (32%). OHCA patients were younger (median age: 65 vs. 74 years) and had less comorbidity. In-hospital mortality was 57% in those with OHCA compared with 67% in those without, but after adjustment the hazard ratio (HR) was 0.99 [95% CI: 0.87–1.11]. Hospital survivors consisted of 1375 MI-CS patients including 531 OHCA patients (39%). Five-year mortality was 22% for OHCA patients and 42% for patients without OHCA (adjusted HR: 0.90 [95% CI: 0.70−0.1.17]). The HR for five-year cardiovascular mortality was 0.80 [95% CI: 0.62−0.98]. Lastly, 5-year rate of heart failure hospitalization was 17% for patients with OHCA compared with 34% in those without (HR: 0.44 [95% CI: 0.34−0.57]). Conclusion: Among patients hospitalized with MI-CS, OHCA did not influence all-cause in-hospital or long-term mortality but was a marker for reduced long-term rates of heart failure hospitalization and cardiovascular mortality. Future randomized studies are needed to improve prognosis of MI-CS, however, the importance of OHCA must be considered.
AB - Aims: Out-of-hospital cardiac arrest (OHCA) is highly prevalent among patients with myocardial infarction and cardiogenic shock (MI-CS). We aimed to examine the prognostic importance of OHCA in patients with MI-CS. Methods: Using Danish nationwide registries, we identified first-time hospitalized MI-CS patients (2010–2015) by OHCA status. Cumulative incidence curves and adjusted Cox regression models were used to compare in-hospital mortality, and among hospital survivors we compared 5-year rates of heart failure hospitalization and mortality. Results: We identified 3107 MI-CS patients of whom 979 presented with OHCA (32%). OHCA patients were younger (median age: 65 vs. 74 years) and had less comorbidity. In-hospital mortality was 57% in those with OHCA compared with 67% in those without, but after adjustment the hazard ratio (HR) was 0.99 [95% CI: 0.87–1.11]. Hospital survivors consisted of 1375 MI-CS patients including 531 OHCA patients (39%). Five-year mortality was 22% for OHCA patients and 42% for patients without OHCA (adjusted HR: 0.90 [95% CI: 0.70−0.1.17]). The HR for five-year cardiovascular mortality was 0.80 [95% CI: 0.62−0.98]. Lastly, 5-year rate of heart failure hospitalization was 17% for patients with OHCA compared with 34% in those without (HR: 0.44 [95% CI: 0.34−0.57]). Conclusion: Among patients hospitalized with MI-CS, OHCA did not influence all-cause in-hospital or long-term mortality but was a marker for reduced long-term rates of heart failure hospitalization and cardiovascular mortality. Future randomized studies are needed to improve prognosis of MI-CS, however, the importance of OHCA must be considered.
KW - Cardiac arrest
KW - Cardiogenic shock
KW - Epidemiology
KW - Myocardial infarction
KW - Prognosis
U2 - 10.1016/j.resuscitation.2021.02.034
DO - 10.1016/j.resuscitation.2021.02.034
M3 - Journal article
C2 - 33662522
AN - SCOPUS:85101931660
VL - 162
SP - 135
EP - 142
JO - Resuscitation
JF - Resuscitation
SN - 0300-9572
ER -
ID: 259046229