Offiah Gregory, Dahly Darren, Shelfah Adel, Quinn Martin O, Masterson Siobhan, Kearney Peter, Deasy Conor
Department of Cardiology, Cork University Hospital, Wilton, Cork, Ireland.
University College Cork, Cork, Ireland.
Resusc Plus. 2025 Aug 5;25:101052. doi: 10.1016/j.resplu.2025.101052. eCollection 2025 Sep.
Out of hospital cardiac arrest (OHCA) can complicate ST segment elevation myocardial infarction (STEMI), with a tenfold increase in mortality compared to those presenting without cardiac arrest. This study aimed to characterise STEMI patients presenting with OHCA to a single centre and to investigate the factors affecting their outcomes.
A retrospective analysis was performed on all patients on the National Out of Hospital Cardiac Arrest Register that presented over a six-year period with OHCA. The hospital's electronic health record was used to collect data on baseline characteristics, STEMI diagnosis, treatment and outcomes.
There were 478 OHCA presentations; 75 (16 %) were diagnosed with STEMI. Mortality rates were significantly lower amongst the STEMI patients (23 % vs 87 %). There was no significant difference in the characteristics of STEMI patients transferred directly to the coronary catheterisation lab (CCL) and initially treated in ED. Over 90 % of STEMI patients were successfully treated with PCI. Mortality was higher in STEMI patients that were initially transferred to ED, with this factor identified as an independent predictor of mortality. However, transfer to CCL after two hours was not associated with increased mortality, when compared to those transferred within an hour of hospital arrival.
Mortality rates amongst studied STEMI patients presenting with OHCA were high. Although transfer to ED was associated with increased mortality, this finding may be explained by confounding factors, including more profound haemodynamic instability precluding STEMI diagnosis, and/or requiring transfer to ED for stabilisation.
院外心脏骤停（OHCA）会使ST段抬高型心肌梗死（STEMI）病情复杂化，与未发生心脏骤停的患者相比，死亡率增加了10倍。本研究旨在对一家单一中心收治的伴有OHCA的STEMI患者进行特征描述，并调查影响其预后的因素。
对国家院外心脏骤停登记册上在六年期间出现OHCA的所有患者进行回顾性分析。利用医院的电子健康记录收集关于基线特征、STEMI诊断、治疗和预后的数据。
有478例OHCA病例；75例（16%）被诊断为STEMI。STEMI患者的死亡率显著较低（23%对87%）。直接转入冠状动脉导管插入实验室（CCL）并在急诊科进行初始治疗的STEMI患者的特征没有显著差异。超过90%的STEMI患者通过经皮冠状动脉介入治疗（PCI）成功治疗。最初转入急诊科的STEMI患者死亡率较高，这一因素被确定为死亡率的独立预测因素。然而，与在入院后一小时内转入的患者相比，两小时后转入CCL与死亡率增加无关。
伴有OHCA的STEMI患者的死亡率较高。尽管转入急诊科与死亡率增加有关，但这一发现可能由混杂因素解释，包括更严重的血流动力学不稳定排除了STEMI诊断，和/或需要转入急诊科进行稳定治疗。
