Scholarlink

<p>In-hospital cardiac arrest in STEMI (STEMI-IHCA) patients poses a formidable mortality risk, yet comprehensive survival data remain scarce. This study compared clinical characteristics and outcomes of STEMI-IHCA versus non-cardiac arrest (non-CA) patients. A cohort of 3311 STEMI patients, treated in the Cath lab and transferred to the intensive cardiac care unit, was retrospectively analyzed over a 21-year period (2003–2024). Of these, 208 (6.3%) had experienced STEMI-IHCA. The mean age was 66.2 ± 12.6&#xa0;years; 77.8% were male. STEMI-IHCA patients more frequently had peripheral artery disease, multivessel disease, and renal impairment. In contrast, non-CA patients had higher rates of dyslipidemia and smoking. A striking 72.7% of STEMI-IHCA cases presented with a shockable rhythm, achieving rapid ROSC (&lt; 1&#xa0;min).Despite this, in-hospital mortality for STEMI-IHCA was drastically higher (25.5 vs. 2.8% for non-CA, <i>p</i> &lt; 0.01), with most deaths occurring within three days (66 vs. 44.2%, <i>p</i> &lt; 0.01). Predictors of in-hospital mortality were IHCA, older age, peripheral artery disease, reduced LVEF, and higher TIMI risk index. Among patients discharged alive, long-term mortality over a 96-month follow-up was similar between STEMI-IHCA and non-CA patients (36.8 vs. 33.3%, <i>p</i> = 0.37), confirmed by Kaplan–Meier analysis (<i>p</i> = 0.73) as well. Our findings confirm the high risk of in-hospital mortality risk associated with STEMI-IHCA. Nevertheless, among patients discharged alive, particularly with rapid ROSC, the long-term prognosis can align remarkably with that of STEMI patients who did not experience IHCA. This underscores the critical importance of prompt intervention as a powerful determinant of favorable long-term outcomes.</p> Graphical abstract <p></p>

错误：搜索内容不能为空，请输入英文关键词
错误：关键词超出字数限制，请精简
高级检索

The IHCA paradox: high early mortality, yet comparable long-term survival in STEMI patients

  • 期刊论文

  • 出版模式：

    开放获取

  • 发表日期：

    2026年7月24日

查看全文
  • Aneta Aleksova,
  • Alessandra Lucia Fluca,
  • Milijana Janjusevic,
  • Giulia Vanin,
  • Gioachino Di Carlo,
  • Giulia Barbati,
  • Filippo Maria Rubbo,
  • Leonardo Viotto,
  • Kenneth Pesenti,
  • Maria Marketou,
  • Daniela Aschieri,
  • Alberto Peratoner,
  • Carlo Pegani,
  • Andrea Perkan,
  • Gianfranco Sinagra,
  • Giuseppe Ristagno

摘要

In-hospital cardiac arrest in STEMI (STEMI-IHCA) patients poses a formidable mortality risk, yet comprehensive survival data remain scarce. This study compared clinical characteristics and outcomes of STEMI-IHCA versus non-cardiac arrest (non-CA) patients. A cohort of 3311 STEMI patients, treated in the Cath lab and transferred to the intensive cardiac care unit, was retrospectively analyzed over a 21-year period (2003–2024). Of these, 208 (6.3%) had experienced STEMI-IHCA. The mean age was 66.2 ± 12.6 years; 77.8% were male. STEMI-IHCA patients more frequently had peripheral artery disease, multivessel disease, and renal impairment. In contrast, non-CA patients had higher rates of dyslipidemia and smoking. A striking 72.7% of STEMI-IHCA cases presented with a shockable rhythm, achieving rapid ROSC (< 1 min).Despite this, in-hospital mortality for STEMI-IHCA was drastically higher (25.5 vs. 2.8% for non-CA, p < 0.01), with most deaths occurring within three days (66 vs. 44.2%, p < 0.01). Predictors of in-hospital mortality were IHCA, older age, peripheral artery disease, reduced LVEF, and higher TIMI risk index. Among patients discharged alive, long-term mortality over a 96-month follow-up was similar between STEMI-IHCA and non-CA patients (36.8 vs. 33.3%, p = 0.37), confirmed by Kaplan–Meier analysis (p = 0.73) as well. Our findings confirm the high risk of in-hospital mortality risk associated with STEMI-IHCA. Nevertheless, among patients discharged alive, particularly with rapid ROSC, the long-term prognosis can align remarkably with that of STEMI patients who did not experience IHCA. This underscores the critical importance of prompt intervention as a powerful determinant of favorable long-term outcomes.

Graphical abstract