Outcomes in non-ST-segment elevation myocardial infarction complicated by in-hospital cardiac arrest based on management strategy.

Autor:	Verghese D; Division of Cardiovascular Medicine, Department of Medicine, Naples Heart Institute, Naples, FL, USA., Bhat AG; Division of Cardiovascular Medicine, Department of Medicine, University of Maryland, Baltimore, MD, USA., Patlolla SH; Department of Cardiovascular Surgery, Mayo Clinic, Rochester, MN, USA., Naidu SS; Division of Cardiovascular Medicine, Westchester Medical Center/New York Medical College, Valhalla, NY, USA., Basir MB; Division of Cardiovascular Medicine, Henry Ford Health System, Detroit, MI, USA., Cubeddu RJ; Division of Cardiovascular Medicine, Department of Medicine, Naples Heart Institute, Naples, FL, USA., Navas V; Division of Cardiovascular Medicine, Department of Medicine, Naples Heart Institute, Naples, FL, USA., Zhao DX; Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA., Vallabhajosyula S; Section of Cardiovascular Medicine, Department of Medicine, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. Electronic address: svallabh@wakehealth.edu.
Jazyk:	angličtina
Zdroj:	Indian heart journal [Indian Heart J] 2023 Nov-Dec; Vol. 75 (6), pp. 443-450. Date of Electronic Publication: 2023 Oct 18.
DOI:	10.1016/j.ihj.2023.10.004
Abstrakt:	Background: There are limited data on in-hospital cardiac arrest (IHCA) complicating non-ST-segment-elevation myocardial infarction (NSTEMI) based on management strategy. Methods: We used National Inpatient Sample (2000-2017) to identify adults with NSTEMI (not undergoing coronary artery bypass grafting) and concomitant IHCA. The cohort was stratified based on use of early (hospital day 0) or delayed (≥hospital day 1) coronary angiography (CAG), percutaneous coronary intervention (PCI), and medical management. Outcomes included incidence of IHCA, in-hospital mortality, adverse events, length of stay, and hospitalization costs. Results: Of 6,583,662 NSTEMI admissions, 375,873 (5.7 %) underwent early CAG, 1,133,143 (17.2 %) received delayed CAG, 2,326,391 (35.3 %) underwent PCI, and 2,748,255 (41.7 %) admissions were managed medically. The medical management cohort was older, predominantly female, and with higher comorbidities. Overall, 63,085 (1.0 %) admissions had IHCA, and incidence of IHCA was highest in the medical management group (1.4 % vs 1.1 % vs 0.7 % vs 0.6 %, p < 0.001) compared to early CAG, delayed CAG and PCI groups, respectively. In adjusted analysis, early CAG (adjusted OR [aOR] 0.67 [95 % confidence interval {CI} 0.65-0.69]; p < 0.001), delayed CAG (aOR 0.49 [95 % CI 0.48-0.50]; p < 0.001), and PCI (aOR 0.42 [95 % CI 0.41-0.43]; p < 0.001) were associated with lower incidence of IHCA compared to medical management. Compared to medical management, early CAG (adjusted OR 0.53, CI: 0.49-0.58), delayed CAG (adjusted OR 0.34, CI: 0.32-0.36) and PCI (adjusted OR 0.19, CI: 0.18-0.20) were associated with lower in-hospital mortality (all p < 0.001). Conclusion: Early CAG and PCI in NSTEMI was associated with lower incidence of IHCA and lower mortality among NSTEMI-IHCA admissions. Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper. (Copyright © 2023 Cardiological Society of India. Published by Elsevier, a division of RELX India, Pvt. Ltd. All rights reserved.)
Databáze:	MEDLINE
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