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

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

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 pati...

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Main Authors: Taro Takeuchi, Yasunori Ueda, Shumpei Kosugi, Kuniyasu Ikeoka, Haruya Yamane, Takuya Ohashi, Takashi Iehara, Kazuho Ukai, Kazuki Oozato, Satoshi Oosaki, Masayuki Nakamura, Tatsuhisa Ozaki, Tsuyoshi Mishima, Haruhiko Abe, Koichi Inoue, Yasushi Matsumura
Format: Article
Language:English
Published: Elsevier 2024-11-01
Series:American Heart Journal Plus
Subjects:
Extracorporeal cardiopulmonary resuscitation
Out-of-hospital cardiac arrest
Myocardial infarction
Percutaneous coronary intervention
Online Access:http://www.sciencedirect.com/science/article/pii/S2666602224001162
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Summary: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.
ISSN:2666-6022

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