TY - JOUR
T1 - Severity of ischemic heart disease and presenting rhythm in patients with out-of-hospital cardiac arrest
AU - Granfeldt, Asger
AU - Adelborg, Kasper
AU - Wissenberg, Mads
AU - Møller Hansen, Steen
AU - Torp-Pedersen, Christian
AU - Christensen, Erika Frischknecht
AU - Andersen, Lars W
AU - Christiansen, Christian Fynbo
N1 - Copyright © 2018 Elsevier B.V. All rights reserved.
PY - 2018/9/1
Y1 - 2018/9/1
N2 - INTRODUCTION: Ischemic heart disease (IHD) is associated with a shockable rhythm in out-of-hospital cardiac arrest (OHCA). However, the impact of IHD severity on first recorded rhythm is unknown. We hypothesized that the strength of the association between IHD and shockable rhythm increases with increasing IHD severity.METHODS: OHCA patients were identified in the Danish Cardiac Arrest Registry (2001-2014). Population-based registries were used to identify chronic diseases, drug prescriptions and cardiac procedures such as coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Severity of IHD was categorized as 1) No diagnosis of IHD, 2) IHD without previous CAG, PCI or CABG, 3) IHD with CAG, 4) IHD with PCI, and 5) IHD with CABG. Adjusted odds ratios (ORs) for a shockable rhythm was computed using multivariable logistic regression.RESULTS: Of 34,749 patients with OHCA, 6325 (18.2%) patients had a diagnosis of IHD. The prevalence of a shockable rhythm was higher for patients with a previous diagnosis of IHD (25.6%) and for those with previous CAG (33.3%), PCI (36.4%) or CABG (34.0%) when compared to patients without IHD (21.2%). IHD was associated with shockable rhythm (OR = 1.69, 95%CI 1.55-1.85) when compared to patients without IHD. The association with shockable rhythm was higher for patients with a history of CAG (OR = 1.92, 95%CI 1.67-2.20) and PCI (OR = 1.93, 95%CI 1.67-2.23), but similar in patients with CABG (OR = 1.69, 95%CI 1.37-2.10).CONCLUSION: IHD was associated with a shockable rhythm, with a moderate increase in the association in patients with a CAG or PCI procedure.
AB - INTRODUCTION: Ischemic heart disease (IHD) is associated with a shockable rhythm in out-of-hospital cardiac arrest (OHCA). However, the impact of IHD severity on first recorded rhythm is unknown. We hypothesized that the strength of the association between IHD and shockable rhythm increases with increasing IHD severity.METHODS: OHCA patients were identified in the Danish Cardiac Arrest Registry (2001-2014). Population-based registries were used to identify chronic diseases, drug prescriptions and cardiac procedures such as coronary angiography (CAG), percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG). Severity of IHD was categorized as 1) No diagnosis of IHD, 2) IHD without previous CAG, PCI or CABG, 3) IHD with CAG, 4) IHD with PCI, and 5) IHD with CABG. Adjusted odds ratios (ORs) for a shockable rhythm was computed using multivariable logistic regression.RESULTS: Of 34,749 patients with OHCA, 6325 (18.2%) patients had a diagnosis of IHD. The prevalence of a shockable rhythm was higher for patients with a previous diagnosis of IHD (25.6%) and for those with previous CAG (33.3%), PCI (36.4%) or CABG (34.0%) when compared to patients without IHD (21.2%). IHD was associated with shockable rhythm (OR = 1.69, 95%CI 1.55-1.85) when compared to patients without IHD. The association with shockable rhythm was higher for patients with a history of CAG (OR = 1.92, 95%CI 1.67-2.20) and PCI (OR = 1.93, 95%CI 1.67-2.23), but similar in patients with CABG (OR = 1.69, 95%CI 1.37-2.10).CONCLUSION: IHD was associated with a shockable rhythm, with a moderate increase in the association in patients with a CAG or PCI procedure.
KW - Acute myocardial infarction
KW - Cardiac arrest
KW - Cardiopulmonary resuscitation
KW - Chronic disease
KW - Ischemic heart disease
KW - Medication use
KW - Non-shockable rhythm
KW - Shockable rhythm
UR - http://www.scopus.com/inward/record.url?scp=85050400411&partnerID=8YFLogxK
U2 - 10.1016/j.resuscitation.2018.07.018
DO - 10.1016/j.resuscitation.2018.07.018
M3 - Journal article
C2 - 30031785
SN - 0300-9572
VL - 130
SP - 174
EP - 181
JO - Resuscitation
JF - Resuscitation
ER -