Interventional cardiology

PCI centres have lasting impact on survival after cardiac arrest


People with an out of hospital cardiac arrest who are taken to a PCI-capable hospital are more likely to be alive over a decade after the event a new report finds.

The data, from the Victorian Ambulance Cardiac Arrest Registry, tracked the 15-year survival outcomes of 3449 patients discharged after out-of-hospital cardiac arrest.

The registry study found that eight out of 10 discharge survivors were alive after five years, seven out of 10 after 10 years and six out of 10 after 15 years.

According to the researchers, led by Emily Andrews from the Department of Research and Evaluation at Ambulance Victoria, only direct transport to a PCI-capable hospital, regardless of whether patients underwent the procedure, and discharge directly home from hospital were associated with improved long-term survival outcomes.

Surprisingly, other factors commonly associated with short-term survival, such as witness status, bystander CPR and emergency service response time, did not seem to influence long-term survival after hospital discharge.

In a linked editorial, Dr Kristian Kragholm, from the Department of Health Science and Technology at Aalborg University in Denmark said the findings were surprising and contradicted the popular belief that cardiac arrest survivors have poor long-term survival.

“It is expected that cardiac arrest survivors should have an increased mortality risk related to the reason for their cardiac arrest, but it is surprising that it stabilises so quickly.”

He added that the impact of PCI-capable hospitals on very long-term survival should be further investigated to improve the outlook for patients.

“This observation may reflect a value of procedures performed or it may reflect a group of patients where the willingness to perform additional procedures was high.”

Pointing to the new finding that survival quickly approaches the general population for these patients, Dr Kragholm suggested that there could be ‘early depletion of a high-risk group of patients such that few interventions are necessary after a time,’ which new studies should investigate.

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