Clinical Features and Outcome-Predictors of Patients with Out-of-Hospital Cardiac Arrest Complicating Acute Myocardial Infarction

Background: Although short-term mortality of acute myocardial infarction (AMI) has decreased dramatically, sudden cardiac arrest is still one of serious complication. We assessed the clinical characteristics and prognosis’ predictors of AMI patients with out-of-hospital cardiac arrest (OHCA). Methods: We retrospectively analyzed consecutive patients with AMI who were treated with emergency percutaneous coronary intervention between 2004 and 2017. Patients with OHCA were compared with those without OHCA. Results: Among 2,101 AMI patients, 95 (4.7%) presented OHCA. Younger age (odds ratio [OR]: 0.95; 95% confidence interval [CI]: 0.93-0.97; p<0.0001), absence of coronary risk factors such as, diabetes mellitus (OR: 0.51; 95% CI: 0.30-0.85; p=0.01) or dyslipidemia (OR: 0.56; 95% CI: 0.36-0.88; p=0.01), left main trunk (LMT) and left anterior descending artery (LAD) as culprit lesion (OR: 3.26; 95% CI: 1.99-5.33; p<0.0001), and renal deficiency (OR: 3.64; 95% CI: 2.27-5.84; p<0.0001) were significantly associated with incidence of OHCA. The 30-day mortality of patients with OHCA was more than 5-hold higher compared with those without OHCA (32.6% vs. 4.5%, p<0.0001). In multivariate logistic regression analysis, LMT or LAD as culprit lesion (OR: 12.18; 95% CI: 2.27-65.41; p=0.04), glucose level (OR: 1.01; 95% CI: 1.00-1.01; p=0.01) and renal deficiency (OR: 3.35; 95% CI: 1.07-10.53; p=0.04) were found as independent predictors of 30-day mortality among AMI patients with OHCA. Conclusions: About 1 of 20 AMI patients presented with OHCA and younger age, absence of coronary risk factors, and anterior wall infarction were associated with OHCA occurrence.