title: Out-of-hospital cardiac arrests in patients with acute ST elevation myocardial infarctions in the East Bohemian region over the period 2002-2004.
abstract: BACKGROUND
  Early reperfusion by direct percutaneous coronary intervention (PCI) in patients with ST segment elevation acute myocardial infarctions (STEMI) with an out-of-hospital cardiac arrest (OHCA) reduces hospital and longterm mortality.
  
  
  OBJECTIVE
  Evaluating the significance of direct PCI for the short-term (discharge from acute hospitalization) and 1-year survival in patients with acute STEMI after OHCA.
  
  
  METHODS
  In this prospective study, from April 1, 2002 up to August 31, 2004, a total of 26 hospitalized individuals (22 men, 4 women, aged 35-79 years, median 58.5) from the East Bohemian region with OHCA (primary group of 718 individuals) with acute STEMI were included. Urgent coronary angiography was performed in 20 individuals, and direct PCI was done in 19 of them. The remaining 6 patients did not undergo angiography.
  
  
  RESULTS
  Fifteen patients (57.7%) survived acute hospitalization, of whom 11 were without neurological deficits. In the subgroup with urgent coronary angiography 14 patients (70%) survived hospitalization, and in the subgroup without coronarography only 1 patient survived hospitalization (16.7%). In the subgroup with PCIs, 13 out of the 19 patients survived (68.4%). None of the patients died during the 1-year follow-up after being discharged from acute hospitalization. According to the urgent coronarography the artery most commonly responsible for the infarction was the left anterior descending artery (50%). Initial TIMI flow grade 0-I was found in 17 patients and grade II-III in 3 individuals. After PCI, irrespective of stent implantation, an optimal angiographic success (TIMI flow grade II-III) was obtained in 17 cases.
  
  
  CONCLUSIONS
  Short-term survival of patients after OHCA with STEMI treated with direct PCI was found to be 68.4%. Out of 6 patients not receiving reperfusion therapy 1 survived (16.7%). Over the course of the 1-year follow-up none of the patients died.
authors.affiliation: 1st Department of Internal Medicine, University Hospital, Hradec Kralove, Czech Republic.
authors.forename: Miloslav
authors.initials: M
authors.lastname: Pleskot
authors.forename: Anush
authors.initials: A
authors.lastname: Babu
authors.forename: Radka
authors.initials: R
authors.lastname: Hazukova
authors.forename: Jakub
authors.initials: J
authors.lastname: Stritecky
authors.forename: Josef
authors.initials: J
authors.lastname: Bis
authors.forename: Jan
authors.initials: J
authors.lastname: Matejka
authors.forename: Eva
authors.initials: E
authors.lastname: Cermakova
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography / Q000706:statistics & numerical data; D018153:Czech Republic / Q000453:epidemiology; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006323:Heart Arrest / Q000401:mortality / Q000628:therapy*; D006760:Hospitalization / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D013997:Time Factors; D016896:Treatment Outcome