Clin Res Cardiol (2021) DOI DOI https://doi.org/10.1007/s00392-021-01843-w

Clinical Outcome of Out-Of-Hospital versus In-Hospital Cardiac Arrest Survivors with Ventricular Tachyarrhythmias

J. Müller1, M. Behnes1, T. Schupp1, L. Reiser1, G. Taton1, T. Reichelt1, D. Ellguth1, N. Engelke1, A. Bollow1, K. J. Weidner1, J. Rusnak1, U. Ansari1, K. A. Mashayekhi2, M. Akin3, D. Große Meininghaus4, M. Borggrefe1, I. Akin1

1I. Medizinische Klinik, Universitätsklinikum Mannheim, Mannheim; 2Klinik für Kardiologie und Angiologie II, Universitäts-Herzzentrum Freiburg / Bad Krozingen, Bad Krozingen; 3Kardiologie und Angiologie, Medizinische Hochschule Hannover, Hannover; 41. Medizinische Klinik, Kardiologie, Angiologie, Carl-Thiem-Klinikum Cottbus gGmbH, Cottbus;

Background: Limited data regarding the prognostic impact of ventricular tachyarrhythmia related out-of hospital cardiac arrest (OHCA) compared to in-hospital cardiac arrest (IHCA) is available. Methods: A large retrospective registry was used including all consecutive patients with ventricular tachycardia (VT) and ventricular fibrillation (VF) on admission from 2002 to 2016. Patients discharged alive after OHCA were compared to patients discharged alive after IHCA using multivariable Cox regression models and propensity-score matching for evaluation of the primary endpoint of long-term all-cause mortality at 2.5 years. Secondary endpoints were all cause mortality at 6 months and cardiac rehospitalization within 2.5 years. Results: From 2422 consecutive patients with ventricular tachyarrhythmias, a total of 524 patients were discharged alive after cardiac arrest (OHCA: 62%; IHCA: 38%). IN about 50% of all cases acute myocardial infarction was the underlying disease leading to ventricular tachyarrhythmia with aborted cardiac arrest. Multivariable Cox regression models revealed that IHCA is associated with increased long-term all-cause mortality at 2.5 years (28% vs. 16%; p=0.001; HR=1.623; 95% CI 1.002-2.629; p=0.049). Impaired long-term mortality in IHCA survivors was still proven after propensity-score matching (28% vs. 19%; log rank p=0.045). IHCA survivors were also associated with higher rates of secondary endpoint all-cause mortality after 6 months (29% vs. 24%, log rank p = 0.001). Cardiac rehospitalization rates at 2.5 years were equally distributed between OHCA and IHCA survivors. Conclusion: In patients presenting with ventricular tachyarrhythmias, IHCA survivors were associated with increased risk for all-cause mortality at 2.5 years as well as after 6 months compared to OHCA survivors. OHCA and IHCA survivors revealed equal cardiac rehospitalization rates at 2.5 years.

https://dgk.org/kongress_programme/jt2021/aP742.html