Photo Credit: Stanislav Tarasov

The following is a summary of “Impact of time to revascularization on outcomes in patients after out-of-hospital cardiac arrest with STEMI,” published in the May 2024 issue of Emergency Medicine by Nakajima, et al.

Following out-of-hospital cardiac arrest (OHCA) with ST-segment elevation on electrocardiography, international guidelines recommended emergency coronary angiography. However, the impact of time to revascularization on outcomes in these patients remained unclear.

The retrospective, multicenter, nationwide observational study included adults (≥18 years) with OHCA due to ST-segment-elevation myocardial infarction (STEMI) who underwent percutaneous coronary intervention (PCI) between 2014 and 2020. The time of the first return of spontaneous circulation (ROSC) was defined as the time of the first ROSC during resuscitation, regardless of pre-hospital or in-hospital setting. The primary outcome was a favorable neurological outcome at 1 month, defined as cerebral performance category 1 or 2. Multivariable logistic regression analysis assessed the association between time to revascularization and favorable neurological outcomes.

The analysis included 547 patients. Multivariable logistic regression revealed that a shorter time from first ROSC to revascularization was associated with higher rates of 1-month favorable neurological outcomes. Specifically, 73.3% of patients in the group with time from first ROSC to revascularization ≤60 minutes achieved favorable neurological outcomes compared to 50.8% in the group with time >120 minutes (adjusted odds ratio [OR] 0.26; 95% CI 0.11–0.56; P for trend 0.015).

In patients with OHCA due to STEMI undergoing PCI, a shorter time to revascularization was significantly associated with higher rates of 1-month favorable neurological outcomes.

Reference: sciencedirect.com/science/article/abs/pii/S0735675724000895