Vol 79, No 12 (2021)
Original article
Published online: 2021-10-12

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Risk of perioperative death and sudden cardiac arrest: A study of 113 456 cases from the National Registry of Invasive Cardiology Procedures (ORPKI) for estimation of the perioperative prognosis

Janusz Sielski1, Karol Kaziród-Wolski1, Zbigniew Siudak1
Pubmed: 34643263
Kardiol Pol 2021;79(12):1328-1334.

Abstract

Background: Despite optimizing treatment of ST-segment elevation myocardial infarction (STEMI), a number of patients die during the invasive procedure or experience sudden cardiac arrest (SCA) that complicates further hospitalization.
Aims: This study aimed to identify the most important risk factors leading to SCA and death in the cath lab among STEMI patients.
Methods: We used data from the National Registry of Invasive Cardiology Procedures (ORPKI) collected between 2014 and 2019. The study population consisted of 113 465 patients. Descriptive statistics, univariate and multiple logistic regression analysis of factors affecting perioperative mortality (PM) and SCA in the cath lab were performed.
Results: Death and SCA occurred in 1549 (1.4%) and 945 (0.8%) patients, respectively. Diabetes (odds ratio [OR], 1.76; P <0.0001), previous brain stroke (OR, 2.26; P <0.0001), prior myocardial infarction (OR, 1.81; P <0.0001), psoriasis (OR, 1.79; P = 0.04), and chronic renal failure (OR, 2.79; P <0.0001) were the strongest predictors of PM. The occurrence of SCA was dependent mainly on diabetes (OR, 1.37; P = 0.0001), previous brain stroke (OR, 2.23; P <0.0001), prior myocardial infarction (OR, 1.73; P <0.0001), psoriasis (OR, 2.03; P = 0.04), and chronic renal failure (OR, 2.79; P <0.0001). Of the pre-hospital factors, the Killip-Kimball class showed the strongest relationship with the two endpoints (OR 3.53; P <0.0001 and OR 2.65; P <0.0001, respectively).
Conclusions: Diabetes, previous brain stroke, myocardial infarction, psoriasis, chronic renal failure, and the Killip-Kimball class were the strongest predictors of PM and SCA in the cath lab among STEMI patients.

References

  1. Cheung W, Flynn M, Thanakrishnan G, et al. Survival after out-of-hospital cardiac arrest in Sydney, Australia. Crit Care Resusc. 2006; 8(4): 321–327.
  2. Chan PS, McNally B, Tang F, et al. CARES Surveillance Group. Recent trends in survival from out-of-hospital cardiac arrest in the United States. Circulation. 2014; 130(21): 1876–1882.
  3. Benjamin EJ, Virani SS, Callaway CW, et al. American Heart Association Council on Epidemiology and Prevention Statistics Committee and Stroke Statistics Subcommittee. Heart Disease and Stroke Statistics — 2018 update: a report from the American Heart Association. Circulation. 2018; 137(12): e67–e492.
  4. Neumar RW, Shuster M, Callaway CW, et al. Part 1: executive summary: 2015 American Heart Association guidelines update for cardiopulmonary resuscitation and emergency cardiovascular care. Circulation. 2015; 132(18 Suppl 2): S315–S367.
  5. Monsieurs KG, Nolan JP, Bossaert LL, et al. ERC Guidelines 2015 Writing Group. European Resuscitation Council Guidelines for Resuscitation 2015: section 1. Executive summary. Resuscitation. 2015; 95: 1–80.
  6. Andersen LW, Holmberg MJ, Berg KM, et al. In-Hospital cardiac arrest: a review. JAMA. 2019; 321(12): 1200–1210.
  7. Kontos MC, Scirica BM, Chen AY, et al. NCDR. Cardiac arrest and clinical characteristics, treatments and outcomes among patients hospitalized with ST-elevation myocardial infarction in contemporary practice: A report from the National Cardiovascular Data Registry. Am Heart J. 2015; 169(4): 515–522.e1.
  8. Lettieri C, Savonitto S, De Servi S, et al. LombardIMA Study Group. Emergency percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by out-of-hospital cardiac arrest: early and medium-term outcome. Am Heart J. 2009; 157(3): 569–575.e1.
  9. Kunadian V, Bawamia B, Maznyczka A, et al. Outcomes following primary percutaneous coronary intervention in the setting of cardiac arrest: a registry database study. Eur Heart J Acute Cardiovasc Care. 2015; 4(1): 6–15.
  10. Demirel F, Rasoul S, Elvan A, et al. Impact of out-of-hospital cardiac arrest due to ventricular fibrillation in patients with ST-elevation myocardial infarction admitted for primary percutaneous coronary intervention: Impact of ventricular fibrillation in STEMI patients. Eur Heart J Acute Cardiovasc Care. 2015; 4(1): 16–23.
  11. Jernberg T. Swedeheart Annual Report 2015. In: Karolinska University Hospital, Huddinge, Stockholm, 2016. https://ki.se/sites/default/files/migrate/ki_annualreport_2015_webb.pdf (April 14, 2021).
  12. Widimsky P, Wijns W, Fajadet J, et al. European Association for Percutaneous Cardiovascular Interventions. Reperfusion therapy for ST elevation acute myocardial infarction in Europe: description of the current situation in 30 countries. Eur Heart J. 2010; 31(8): 943–957.
  13. 20 MedCalc Statistical Software. Version 19.7. MedCalc Software; 2021. https://www.medcalc.org (March 15, 2021).
  14. Gąsior M, Pres D, Wojakowski W, et al. Causes of hospitalization and prognosis in patients with cardiovascular diseases. Secular trends in the years 2006-2014 according to the SILesian CARDiovascular (SILCARD) database. Pol Arch Med Wewn. 2016; 126(10): 754–762.
  15. Karwowski J, Gierlotka M, Gąsior M, et al. Relationship between infarct artery location, acute total coronary occlusion, and mortality in STEMI and NSTEMI patients. Pol Arch Intern Med. 2017; 127(6): 401–411.
  16. Januszek R, Siudak Z, Malinowski KP, et al. Aspiration thrombectomy in patients with acute myocardial infarction-5-year analysis based on a large national registry (ORPKI). J Clin Med. 2020; 9(11): 3610.
  17. Tokarek T, Siudak Z, Dziewierz A, et al. Clinical outcomes in nonagenarians undergoing a percutaneous coronary intervention: data from the ORPKI Polish National Registry 2014–2016. Coron Artery Dis. 2018; 29(7): 573–578.
  18. Fröbert O, Lagerqvist Bo, Olivecrona GK, et al. TASTE Trial. Thrombus aspiration during ST-segment elevation myocardial infarction. N Engl J Med. 2013; 369(17): 1587–1597.
  19. Kim YH, Her AY, Jeong MHo, et al. Two-Year clinical outcomes between prediabetic and diabetic patients with STEMI and multivessel disease who underwent successful PCI using drug-eluting stents. Angiology. 2021; 72(1): 50–61.
  20. Brown JR, Solomon RJ, Robey RB, et al. Chronic kidney disease progression and cardiovascular outcomes following cardiac catheterization — a population-controlled study. J Am Heart Assoc. 2016; 5(10): e003812.
  21. Ismail MD, Jalalonmuhali M, Azhari Z, et al. NCVD-PCI investigators. Outcomes of STEMI patients with chronic kidney disease treated with percutaneous coronary intervention: the Malaysian National Cardiovascular Disease Database — Percutaneous Coronary Intervention (NCVD-PCI) registry data from 2007 to 2014. BMC Cardiovasc Disord. 2018; 18(1): 184.
  22. Fraticelli L, Kleitz O, Claustre C, et al. RESCUe Research Group. Comparison of the pathways of care and life courses between first-time ST-elevation myocardial infarction (STEMI) and STEMI with prior MI: findings from the OSCAR registry. BMJ Open. 2020; 10(11): e038773.
  23. Scholz KH, Maier SKG, Maier LS, et al. Impact of treatment delay on mortality in ST-segment elevation myocardial infarction (STEMI) patients presenting with and without haemodynamic instability: results from the German prospective, multicentre FITT-STEMI trial. Eur Heart J. 2018; 39(13): 1065–1074.
  24. Pana TA, Wood AD, Mamas MA, et al. Norfolk and Norwich Stroke and TIA Register Steering Committee Collaborators. Myocardial infarction after acute ischaemic stroke: Incidence, mortality and risk factors. Acta Neurol Scand. 2019; 140(3): 219–228.
  25. Hariri E, Tisminetzky M, Lessard D, et al. Twenty-five-year (1986–2011) trends in the incidence and death rates of stroke complicating acute myocardial infarction. Am J Med. 2018; 131(9): 1086–1094.
  26. Liao J, O'Donnell MJ, Silver FL, et al. Investigators of the Registry of the Canadian Stroke Network. In-hospital myocardial infarction following acute ischaemic stroke: an observational study. Eur J Neurol. 2009; 16(9): 1035–1040.
  27. Siudak Z, Wysocka-Dubielecka K, Malinowski K, et al. Psoriasis is an independent predictor of increased risk of allergic reaction during percutaneous coronary interventions. Big data analysis from the Polish National PCI Registry (ORPKI). Cardiol J. 2020; 27(3): 278–284.
  28. Karbach S, Hobohm L, Wild J, et al. Impact of psoriasis on mortality rate and outcome in myocardial infarction. J Am Heart Assoc. 2020; 9(18): e016956.
  29. Killip T, Kimball J. Treatment of myocardial infarction in a coronary care unit. A two year experience with 250 patients . Am J Cardiol. 1967; 20(4): 457–464.
  30. Mello BH, Oliveira GB, Ramos RF, et al. Validation of the Killip-Kimball classification and late mortality after acute myocardial infarction. Arq Bras Cardiol. 2014; 103(2): 107–117.
  31. Redfors B, Furer A, Selker HP, et al. Effect of smoking on outcomes of primary PCI in patients with STEMI. J Am Coll Cardiol. 2020; 75(15): 1743–1754.
  32. Gennaro G, Brener SJ, Redfors B, et al. Effect of smoking on infarct size and major adverse cardiac events in patients with large anterior ST-elevation myocardial infarction (from the INFUSE-AMI trial). Am J Cardiol. 2016; 118(8): 1097–1104.
  33. Niedziela JT, Hiczkiewicz J, Kleinrok A, et al. Prevalence, characteristics, and prognostic implications of type 2 diabetes in patients with myocardial infarction: the Polish Registry of Acute Coronary Syndromes (PL‑ACS) annual 2018 report. Kardiol Pol. 2020; 78(3): 243–246.
  34. Nadolny K, Ładny JR, Gałązkowski R, et al. Medical emergency team interventions in patients with ST-segment elevation myocardial infarction in Poland in 2018. Kardiol Pol. 2020; 78(4): 292–299.



Polish Heart Journal (Kardiologia Polska)