title: One-year clinical impact of cardiac arrest in patients with first onset acute ST-segment elevation myocardial infarction.
abstract: BACKGROUND
  Cardiac arrest complicating acute ST elevation myocardial infarction (STEMI) is known to be associated with increased in-hospital mortality. However, little is known about the long-term outcomes after cardiac arrest complicating first onset STEMI in contemporary percutaneous coronary intervention (PCI) era.
  
  
  METHODS
  We analyzed 7942 consecutive patients who were diagnosed with STEMI and had no previous history of MI. They were divided into two groups according to the presence of cardiac arrest (group I, patients with cardiac arrest; n=481, group II, patients without cardiac arrest; n=7641).
  
  
  RESULTS
  In a stepwise multivariate model, previous history of chronic kidney disease, high serum level of glucose and low high density lipoprotein-cholesterol was an independent predictor of cardiac arrest complicating STEMI. Group I had significantly higher in-hospital mortality (adjusted hazard ratio [HR] 3.06, 95% confidence interval [CI] 2.08-4.51, p<0.001) and 30-day mortality after hospital discharge (adjusted HR 2.92, 95% CI 1.86-4.58, log-rank p<0.001). However, there was no significant increase in mortality beyond 30 days (6-month, adjusted HR 1.46, 95% CI 0.45-4.77, log rank p=0.382; 1-year, adjusted HR 1.84, 95% CI 0.83-4.05, log-rank p=0.107). Also, there were no significant differences in 6-month and 1-year major adverse cardiac events in 30-day survivors. Performing PCI was associated with decreased 12-month mortality in 30-day survivors.
  
  
  CONCLUSIONS
  Although patients with cardiac arrest complicating first onset STEMI had higher in-hospital and 30-day mortality after hospital discharge, cardiac arrest itself did not have any residual impact on mortality as well as clinical outcomes.
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Ki Hong
authors.initials: KH
authors.lastname: Lee
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea. Electronic address: myungho@chollian.net.
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.lastname: YoungkeunAhn
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Sung Soo
authors.initials: SS
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Shi Hyun
authors.initials: SH
authors.lastname: Rhew
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Young Wook
authors.initials: YW
authors.lastname: Jeong
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Soo Young
authors.initials: SY
authors.lastname: Jang
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Jae Yeong
authors.initials: JY
authors.lastname: Cho
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Hae Chang
authors.initials: HC
authors.lastname: Jeong
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Keun-Ho
authors.initials: KH
authors.lastname: Park
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Nam Sik
authors.initials: NS
authors.lastname: Yoon
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Doo Sun
authors.initials: DS
authors.lastname: Sim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Hyun Ju
authors.initials: HJ
authors.lastname: Yoon
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Kye Hun
authors.initials: KH
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Young Joon
authors.initials: YJ
authors.lastname: Hong
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Park
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Ju Han
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Jeong Gwan
authors.initials: JG
authors.lastname: Cho
authors.affiliation: Chonnam National University Hospital, Gwangju, South Korea.
authors.forename: Jong Chun
authors.initials: JC
authors.lastname: Park
authors.affiliation: Chungbuk National University Hospital, Chungju, South Korea.
authors.forename: Myeong Chan
authors.initials: MC
authors.lastname: Cho
authors.affiliation: East West Neo Medical Center, Seoul, South Korea.
authors.forename: Chong Jin
authors.initials: CJ
authors.lastname: Kim
authors.affiliation: Yeungnam University Hospital, Daegu, South Korea.
authors.forename: Young Jo
authors.initials: YJ
authors.lastname: Kim
mesh_terms: D000208:Acute Disease; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006323:Heart Arrest / Q000175:diagnosis* / Q000401:mortality*; D017052:Hospital Mortality / Q000639:trends*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000401:mortality*; D011446:Prospective Studies; D012042:Registries; D056910:Republic of Korea / Q000453:epidemiology; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D016896:Treatment Outcome
keywords: Cardiac; Death; Heart arrest; Myocardial infarction; Sudden