Acute cardiac care & resuscitation
Direct transfer to primary percutaneous coronary intervention centres following out-of-hospital cardiac arrest: longer term outcomes and influences on survival
Authors' conclusion
In patients with OHCA and ST-elevation, direct transfer to PPCI centres was associated with improved survival up to 3 years. This advantage appears driven predominantly by early in-hospital outcomes, supporting direct triage for rapid reperfusion and optimised post-resuscitation care.
Study context
- Population
- Adults with out-of-hospital cardiac arrest (OHCA), return of spontaneous circulation and ST-elevation on post-arrest ECG, April 2015 to September 2022patients included
- Participants
- 613 adults
- Exposure
- Direct transfer of OHCA patients with ST-elevation compared with indirect transfer via a non-PPCI hospital
- Direct transfern = 359reference
- Indirect transfern = 254
- Outcome
- All-cause mortality (cumulative incidence of death)
- Follow-up
- 3 years
Methodological detailsnational myocardial infarction registry within a regional emergency service network, adjusted FPSMs, landmark analyses at 30 days and 1 year
- National myocardial infarction registry within a regional emergency service network
- Adjusted FPSMs
- Landmark analyses at 30 days and 1 year
Main finding
As reported in the abstract
Absolute risk difference
13.5%
By group
Observational data: associations, not effects.
Further findings
Call-to-balloon time
Survival to discharge
| Outcome | Adjusted HR (95% CI) | |
|---|---|---|
| Mortality · 30 daysHigher mortality with indirect transfer · landmark analysis · adjusted | 2.48 (1.08–5.73) | |
| 0.20.5125Adjusted hazard ratio (log scale) |
Mortality · 30 days
- Excess risk attenuating thereafter and stabilising after ≈6 months
Original publication
Direct transfer to primary percutaneous coronary intervention centres following out-of-hospital cardiac arrest: longer term outcomes and influences on survival. Heart. Published 7 September 2026. doi:10.
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