Acute cardiac care & resuscitation
Revascularization During Cardiac Arrest While Receiving Extracorporeal Life Support in Patients With Acute Myocardial Infarction
Authors' conclusion
Among patients with AMI and refractory OHCA treated with ECPR, one-third did not have sustained ROSC prior to PCI. Of those, two-thirds achieved sustained ROSC following reperfusion and one-fifth survived to discharge.
Study context
- Population
- Adults with acute myocardial infarction (AMI) and refractory out-of-hospital cardiac arrest (OHCA) treated with extracorporeal cardiopulmonary resuscitation (ECPR) who underwent primary percutaneous coronary intervention (PCI) during ongoing cardiac arrest, Japan, 2013–2018of 671 with PCI and ECPR
- Participants
- 251 adults
- Outcome
- In-hospital mortality
Methodological detailsmulticentre, registry, 30 institutions
- Multicentre
- Registry
- 30 institutions
Main finding
As reported in the abstract
Outcomes after coronary reperfusion · hospital discharge
Sustained return of spontaneous circulation (ROSC)
64.9%
163/251
Survival
21.1%
53/251
Favourable neurological status at discharge
10.4%
26/251
Observational data: associations, not effects.
Further findings
Predictors of survival to discharge (multivariable)
| OR (95% CI) | ||
|---|---|---|
| Intermittent prehospital ROSCMixed effects logistic regression | 5.22 (1.54–17.79) | |
| Shorter time to ECPR initiationMixed effects logistic regression | 0.89 (0.82–0.98) | |
| Postprocedural TIMI flow grade 3Mixed effects logistic regression | 5.08 (1.50–17.22) | |
| 0.050.21520Odds ratio (log scale) |
Original publication
Revascularization During Cardiac Arrest While Receiving Extracorporeal Life Support in Patients With Acute Myocardial Infarction. JACC Adv. Published 13 December 2024. doi:10.
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