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. 2024 Oct 14:47:100473.
doi: 10.1016/j.ahjo.2024.100473. eCollection 2024 Nov.

The impact of door to extracorporeal cardiopulmonary resuscitation time on mortality and neurological outcomes among out-of-hospital cardiac arrest acute myocardial infarction patients treated by primary percutaneous coronary intervention

Taro Takeuchi  1 , Yasunori Ueda  1 , Shumpei Kosugi  2 , Kuniyasu Ikeoka  1 , Haruya Yamane  1 , Takuya Ohashi  1 , Takashi Iehara  1 , Kazuho Ukai  1 , Kazuki Oozato  1 , Satoshi Oosaki  1 , Masayuki Nakamura  1 , Tatsuhisa Ozaki  1 , Tsuyoshi Mishima  1 , Haruhiko Abe  1 , Koichi Inoue  1 , Yasushi Matsumura  1
Affiliations

The impact of door to extracorporeal cardiopulmonary resuscitation time on mortality and neurological outcomes among out-of-hospital cardiac arrest acute myocardial infarction patients treated by primary percutaneous coronary intervention

Taro Takeuchi et al. Am Heart J Plus. .

Abstract

Background: Few previous studies evaluated the impact of time from the hospital arrival to the implementation of extracorporeal cardiopulmonary resuscitation (ECPR) (door to ECPR time) on outcomes among out-of-hospital cardiac arrest (OHCA) acute myocardial infarction (MI) patients.

Methods: 50 patients with OHCA who received both ECPR and percutaneous coronary intervention (PCI) at Cardiovascular Division, NHO Osaka National Hospital were analyzed. Patients were divided into 2 groups according to the median of door to ECPR time. The primary outcome was all-cause death. Survival analyses were conducted to compare all-cause mortality at 90 days between 2 groups. Neurological outcome at 30 days was also compared between 2 groups using the Cerebral Performance Category (CPC).

Results: The multivariable Cox proportional-hazards model showed that all-cause mortality at 90 days was significantly higher among patients with door to ECPR time ≥ 25 min compared with those with door to ECPR time < 25 min (adjusted hazard ratio [HR]: 3.14; 95 % confidence interval [CI]: 1.21-8.18). The proportion of patients with CPC at 30 days ≤ 2 was significantly higher among patients with shorter door to ECPR time (P = 0.048).

Conclusion: Among patients with OHCA due to acute MI who received ECPR and PCI, the shorter door to ECPR time was associated with the lower mortality and favorable neurological outcomes.

Keywords: Extracorporeal cardiopulmonary resuscitation; Myocardial infarction; Out-of-hospital cardiac arrest; Percutaneous coronary intervention.

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Conflict of interest statement

The authors declare the following financial interests/personal relationships which may be considered as potential competing interests: Yasunori Ueda reports a relationship with 10.13039/100001316Abbott, 10.13039/501100002973Daiichi-Sankyo, Teijin, Japan Lifeline, OrbusNeich, Janssen, Otsuka, Ono, Eli Lilly, Astellas, 10.13039/100002429Amgen, 10.13039/100001003Boehringer Ingelheim, and 10.13039/100004336Novartis that includes: funding grants. Yasunori Ueda reports a relationship with Abbott, Kowa, Bayer, Daiichi-Sankyo, Nipro, Takeda, AstraZeneca, Japan Lifeline, Novartis, Ono, Boehringer Ingelheim, and Amgen that includes: speaking and lecture fees. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
The flow diagram of data processing.
Fig. 2
Fig. 2
Kaplan-Meier curve for the primary outcome.
Fig. 3
Fig. 3
The association between door to ECPR time CPC at 30 days.
See this image and copyright information in PMC

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