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Prehospital cardiac arrest: a marker for higher mortality in patients with acute myocardial infarction and moderately reduced left ventricular function: results from the MITRA plus registry

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Abstract

Background

According to the current guidelines for acute myocardial infarction, ventricular fibrillation during the acute phase of myocardial infarction is no indication for specific treatment like ICD implantation. Primary objective of our study was to evaluate the prognostic significance of cardiac arrest within the acute phase of myocardial infarction in patients with moderately reduced left ventricular function.

Methods and Results

From 1994 until 2004, we included 7111 patients with acute STEMI and an LVEF >30% from the MITRA plus registry who were discharged alive from hospital and had a complete follow up. We compared long term prognosis on total mortality in patients with and without prehospital cardiac arrest. 286 out of 7111 patients (4%) with moderately reduced LVEF >30% after STEMI had prehospital cardiac arrest and were discharged alive from hospital. In these patients, total mortality during a mean follow up of 13 months was 13.6% compared to 8.7% in patients without cardiac arrest, although patients with cardiac arrest were younger and had less risk factors. Higher mortality after cardiac arrest was independent from gender, risk factors and medical treatment. Only in patients with preserved LVEF >55% after STEMI, mortality was equal in patients with and without cardiac arrest.

Conclusion

Prehospital cardiac arrest in the acute phase of STEMI is an independent risk indicator for higher mortality in patients with moderately reduced left ventricular function (LVEF 30–55%). To evaluate the prognostic impact of the implantation of an ICD in these patients, further investigation is needed.

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Authors and Affiliations

  1. Herzzentrum Ludwigshafen, Bremserstrasse 79, 67063, Ludwigshafen, Germany

    Margit Strauß MD, Anselm Kai Gitt MD, Torsten Becker MD, Thomas Kleemann MD, Rudolf Schiele MD, Harald Darius MD, Claus Jünger MPH, Jochen Senges MD, FESC & Karlheinz Seidl MD, FESC

  2. Institut für Herzinfarktforschung, Ludwigshafen, Germany

    Claus Jünger MPH

  3. Vivantes Klinikum, Berlin-Neukölln, Germany

    Harald Darius MD

Authors
  1. Margit Strauß MD
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  2. Anselm Kai Gitt MD
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  3. Torsten Becker MD
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  4. Thomas Kleemann MD
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  5. Rudolf Schiele MD
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  6. Harald Darius MD
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  7. Claus Jünger MPH
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  8. Jochen Senges MD, FESC
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  9. Karlheinz Seidl MD, FESC
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for the MITRA Plus Study Group

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Correspondence to Margit Strauß MD.

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Strauß, M., Gitt, A.K., Becker, T. et al. Prehospital cardiac arrest: a marker for higher mortality in patients with acute myocardial infarction and moderately reduced left ventricular function: results from the MITRA plus registry. Clin Res Cardiol 97, 748–752 (2008). https://doi.org/10.1007/s00392-008-0673-6

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  • DOI: https://doi.org/10.1007/s00392-008-0673-6

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