Factors associated with the occurrence of cardiac arrest during hospitalization for acute myocardial infarction in the second national registry of myocardial infarction in the US

Cardiac arrest can occur as a complication of acute myocardial infarction ( AMI). To date, few studies have described factors associated with cardiac a rrest occurrence and survival during hospitalization for treatment of AMI. We used data from a large national registry of hospitalized AMI patients to identify these factors. Data were collected from 1073 participating instit utions, representing 14.4%;. of US hospitals. Hospital site coordinators co nducted periodic chart reviews for AMI patients and data were submitted to an independent center for periodic review. Univariate analysis and multivar iate logistic regression were used to identify factors associated with card iac arrest. We found that cardiac arrest occurred in 4.8% (14 725/305 813) of hospitalized AMI patients. The survival rate to hospital discharge for t hese individuals was 29.4%. Sustained ventricular tachycardia or fibrillati on (VT/VF) was present in 34.7% and was associated with a higher rate of su rvival to hospital discharge compared to cardiac arrest patients without a ventricular tachyarrhythmia (47.5 vs. 19.8%, P < 0.00001). Hypotension (ini tial systolic BP < 90 mmHg), q-wave AMI, old age. heart failure and initial heart rate abnormalities (bradycardia or tachycardia) were associated with a higher prevalence of cardiac arrest. A higher percentage of women compar ed to men experienced cardiac arrest (6.0 vs. 4.4%, P < 0.0001). Cardiac ar rest prevalence was lower in patients with inferior wall infarction than in other types of ST-elevation infarction. Use of reperfusion therapy (PTCA o r tPA) was associated with improved survival compared to hospitalized AMI p atients who did not receive such therapy. (C) 2001 Elsevier Science Ireland Ltd. All rights reserved.