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Outcome in transferred and nontransferred patients after primary percutaneous coronary intervention for ischaemic out‐of‐hospital cardiac arrest
Author(s) -
Peels Hans O.,
Jessurun Gillian A.J.,
van der Horst Iwan C.C.,
Arnold Alfons E.R.,
Piers Lieuwe H.,
Zijlstra Felix
Publication year - 2008
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.21265
Subject(s) - medicine , conventional pci , percutaneous coronary intervention , myocardial infarction , cardiopulmonary resuscitation , cardiology , resuscitation , surgery
Objective: To evaluate the impact of transfer from a referral hospital to a center with primary percutaneous coronary intervention (PCI) facilities of ST‐segment elevation myocardial infarction (STEMI) patients after successful cardiopulmonary resuscitation (CPR). Methods: We studied all STEMI patients with successful CPR admitted to two centers after out‐of‐hospital cardiac arrest and CPR from January 2004 to December 2005. Subjects were divided in a transferred (PCI performed after referral from center without PCI facility) and nontransferred (PCI performed in hospital of admission, i.e. center with PCI facility) group. Results: A total of 44 patients were included. Mean age was 61 ± 13 year and 35 (80%) patients were male. Of all patients 16 (36%) were transferred for treatment. After treatment, the left ventricular function was preserved in 4 (25%) patients of the transferred group are compared with 17 (61%) of the nontransferred group ( P = 0.024). In‐hospital mortality after follow‐up did not differ with 7 (44%) survivors in the transferred group versus 15 (54%) survivors in the nontransferred group ( P = 0.76). Patients who did not survive were more often treated with endotracheal intubation (100% versus 71%, P = 0.019), had more often an occlusion of the proximal right coronary artery (37% versus 10%, P = 0.02), and higher glucose levels at admission (15.2 mmol/l ± 4.4 versus 11.5 mmol/l ± 4.2, P = 0.009). Conclusion: In conclusion, no difference in outcome was observed between nontransferred and transferred patients. Therefore, we suggest that transfer for primary PCI for STEMI patients after successful CPR should be considered. © 2008 Wiley‐Liss, Inc.