Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Cardiology - Tekirdağ, Turkey.
Tekirdağ Namık Kemal University, Faculty of Medicine, Department of Emergency - Tekirdağ, Turkey.
Rev Assoc Med Bras (1992). 2024 Sep 2;70(8):e20240647. doi: 10.1590/1806-9282.20240647. eCollection 2024.
Sudden cardiac death or arrest describes an unexpected cardiac cause-related death or arrest that occurs rapidly out of the hospital or in the emergency room. This study aimed to reveal the relationship between coronary angiographic findings and cardiac death secondary to acute ST-elevation myocardial infarction.
Patients presenting with acute ST-elevation myocardial infarction complicated with cardiac arrest were included in the study. The severity of coronary artery disease, coronary chronic total occlusion, coronary collateral circulation, and blood flow in the infarct-related artery were recorded. Patients were divided into two groups, namely, deaths secondary to cardiac arrest and survivors of cardiac arrest.
A total of 161 cardiac deaths and 42 survivors of cardiac arrest were included. The most frequent (46.3%) location of the culprit lesion was on the proximal left anterior descending artery. The left-dominant coronary circulation was 59.1%. There was a difference in the SYNTAX score (16.3±3.8 vs. 13.6±1.9; p=0.03) and the presence of chronic total occlusion (19.2 vs. 0%; p=0.02) between survivors and cardiac deaths. A high SYNTAX score (OR: 0.38, 95%CI: 0.27-0.53, p<0.01) was determined as an independent predictor of death secondary to cardiac arrest.
The chronic total occlusion presence and SYNTAX score may predict death after cardiac arrest secondary to ST-elevation myocardial infarction.
心源性猝死或骤停描述的是一种意料之外的心脏相关原因导致的死亡或骤停，发生于医院外或急诊室。本研究旨在揭示冠状动脉造影结果与急性 ST 段抬高型心肌梗死继发心源性死亡之间的关系。
本研究纳入了急性 ST 段抬高型心肌梗死合并心搏骤停的患者。记录了冠状动脉疾病的严重程度、冠状动脉慢性完全闭塞、冠状动脉侧支循环以及梗死相关动脉的血流情况。患者被分为心搏骤停继发死亡组和心搏骤停存活组。
共纳入 161 例心搏骤停死亡和 42 例心搏骤停存活患者。罪犯病变最常见的部位（46.3%）位于左前降支近段。左优势型冠状动脉循环占 59.1%。心搏骤停存活组和心搏骤停死亡组在 SYNTAX 评分（16.3±3.8 比 13.6±1.9；p=0.03）和慢性完全闭塞的存在（19.2%比 0%；p=0.02）方面存在差异。高 SYNTAX 评分（OR：0.38，95%CI：0.27-0.53，p<0.01）被确定为心搏骤停继发死亡的独立预测因素。
慢性完全闭塞的存在和 SYNTAX 评分可能预测 ST 段抬高型心肌梗死继发心搏骤停后的死亡。
