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. 2022 Oct 24;22(1):169.
doi: 10.1186/s12873-022-00732-3.

Risk factors for sudden cardiac arrest in patients with ST-segment elevation myocardial infarction: a retrospective cohort study

Chang-Hung Chu #  1   2 , Hong-Mo Shih #  1   2   3 , Shao-Hua Yu  2   4 , Shih-Sheng Chang  1   5 , Ji-Syuan Sie  2 , Fen-Wei Huang  2 , Tai-Yi Hsu  6   7   8
Affiliations

Risk factors for sudden cardiac arrest in patients with ST-segment elevation myocardial infarction: a retrospective cohort study

Chang-Hung Chu et al. BMC Emerg Med. .

Abstract

Background: Sudden cardiac arrest (SCA) is a critical complication of acute myocardial infarction, especially ST-segment elevation myocardial infarction (STEMI). This study identified the risk factors for SCA in patients with STEMI before receiving catheterization.

Methods: We retrospectively analyzed the data of patients with STEMI and cardiac arrest who presented to a tertiary care center in Taiwan between January 1, 2016, and December 31, 2019. Only patients with coronary artery disease (CAD) confirmed by coronary angiography were included in this study. We collected the patients' demographic and clinical data, such as age, sex, medical history, estimated glomerular filtration rate (eGFR), and coronary angiographic findings. The primary outcome of this study was SCA in patients with STEMI. Continuous and nominal variables were compared using the two-sample Student's t-test and chi-squared test, respectively. The results of logistic regression were subjected to multivariate analysis with adjustment for possible confounders.

Results: A total of 920 patients with STEMI and coronary angiography-documented CAD and 108 patients with SCA who presented between January 1, 2016, and December 31, 2019, were included. The bivariate logistic regression analysis of patients' demographic data revealed that patients with STEMI and SCA were slightly younger, were more likely to have diabetes mellitus, and had a lower eGFR than did the patients without SCA. The coronary angiographic findings indicated a higher prevalence of left main CAD and three-vessel disease in patients with SCA than in patients without SCA. Multivariate logistic regression revealed that left main CAD (odds ratio [OR]: 3.77; 95% confidence interval [CI], 1.84 to 7.72), a lower eGFR (OR: 0.97; 95% CI, 0.96 to 0.98), and younger age (OR: 0.98; 95% CI, 0.96 to 0.99) were the risk factors for SCA in patients with STEMI.

Conclusions: Left main CAD, lower eGFR, and younger age are the risk factors for cardiac arrest in patients with acute myocardial infarction.

Keywords: Coronary artery disease; Percutaneous coronary intervention; ST-segment elevation myocardial infarction; Sudden cardiac arrest.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Flowchart of patient enrollment. AMI, acute myocardial infarction; SCA, sudden cardiac arrest; NSTEMI, non-ST-segment elevation myocardial infarction; STEMI, ST-segment elevation myocardial infarction; CAG, coronary angiogram; CAD, coronary heart disease; ROSC, return of spontaneous circulation
Fig. 2
Fig. 2
Risk of sudden cardiac arrest in patients with acute myocardial infarction with and without left main coronary artery disease. CAD, coronary artery disease
Fig. 3
Fig. 3
Survival-to-discharge rate after sudden cardiac arrest in patients with acute myocardial infarction with and without left main coronary artery disease. CAD, coronary artery disease
Fig. 4
Fig. 4
Proportion of those with survival-to-discharge who also had favorable neurological function after sudden cardiac arrest among patients with acute myocardial infarction with and without left main coronary artery disease. CAD, coronary artery disease
See this image and copyright information in PMC

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