title: Out-of-hospital cardiac arrest in patients treated with primary PCI for STEMI. Long-term follow up data from EUROTRANSFER registry.
abstract: OBJECTIVE
  Our aim was to describe long-term outcome of OHCA patients in a cohort of STEMI patients treated by primary PCI based on the EUROTRANSFER Registry data.
  
  
  BACKGROUND
  The occurrence of cardiac arrest is associated with impaired survival. There are limited number of studies reporting outcome of STEMI patients with out-of-hospital cardiac arrest (OHCA) treated by primary percutaneous coronary intervention (PCI). The recently published resuscitation guidelines of the European Resuscitation Council (ERC) support immediate angiography/PCI or fibrinolysis in these patients in order to improve survival.
  
  
  METHODS
  Consecutive data on 1650 STEMI patients, transferred for primary PCI in hospital STEMI networks between November 2005 and January 2007 from 7 countries in Europe were gathered. Patients were divided into two groups: OHCA group - 42 patients and no OHCA group - 1608 patients.
  
  
  RESULTS
  Baseline demographics, clinical characteristic on admission to cathlab and past medical history were similar in both groups. Cardiogenic shock on admission or acute heart failure defined as Killip 3+4 was more frequently observed in OHCA group. The in-hospital mortality was similar, however, 1-year mortality was 19.1% in the OHCA group vs 8.1% in no OHCA group (p=0.011) and remained significant after exclusion of patients in cardiogenic shock on admission.
  
  
  CONCLUSIONS
  STEMI patients treated with primary PCI with out-of-hospital cardiac arrest have higher long-term mortality than no OHCA patients. However, resuscitation prior to cathlab admission is not an independent predictor of long-term adverse outcome. No differences in in-hospital mortality were noticed.
authors.affiliation: Department of Interventional Cardiology, Jagiellonian University Medical College, 17 Kopernika St., 31-501 Krakow, Poland. zbigniew.siudak@gmail.com
authors.forename: Zbigniew
authors.initials: Z
authors.lastname: Siudak
authors.forename: Ralf
authors.initials: R
authors.lastname: Birkemeyer
authors.forename: Artur
authors.initials: A
authors.lastname: Dziewierz
authors.forename: Tomasz
authors.initials: T
authors.lastname: Rakowski
authors.forename: Krzysztof
authors.initials: K
authors.lastname: Zmudka
authors.forename: Jacek S
authors.initials: JS
authors.lastname: Dubiel
authors.forename: Dariusz
authors.initials: D
authors.lastname: Dudek
mesh_terms: D015906:Angioplasty, Balloon, Coronary; D016009:Chi-Square Distribution; D017023:Coronary Angiography; D004562:Electrocardiography; D005060:Europe; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000628:therapy*; D058687:Out-of-Hospital Cardiac Arrest / Q000401:mortality / Q000628:therapy*; D011446:Prospective Studies; D012042:Registries; D018709:Statistics, Nonparametric; D015996:Survival Rate; D016896:Treatment Outcome