Impact of availability of catheter laboratory facilities on management and outcomes of acute myocardial infarction presenting with out of hospital cardiac arrest. (January 2022)

• Record Type: Journal Article
• Authors: Dafaalla, Mohamed; Rashid, Muhammad; Sun, Louise; Quinn, Tom; Timmis, Adam; Wijeysundera, Harindra; Bagur, Rodrigo; Michos, Erin; Curzen, Nick; Mamas, Mamas A.
• Is Part Of: Resuscitation. Volume 170(2022)
• Page Start: 327
• Page End: 334
• Publication Date: 2022-01
• Subjects: Resuscitation -- Periodicals; Resuscitation -- Periodicals; Réanimation -- Périodiques; Electronic journals; 616.025
• DOI: 10.1016/j.resuscitation.2021.10.031
• Languages: English
• ISSNs: 0300-9572

Abstract

Graphical abstract: Abstract: Objectives: We aimed to identify whether the availability of catheter laboratory affects clinical outcomes of out-of-hospital cardiac arrest (OHCA) complicating myocardial infarction (AMI). Methods: Patients admitted with a diagnosis of AMI and OHCA from the Myocardial Ischaemia National Audit Project (MINAP) between 2010 to 2017 were stratified into three groups based on initial hospital's catheter laboratory status: hospitals without a catheter laboratory (No-catheter lab hospitals), hospitals with diagnostic catheter laboratory (Diagnostic hospitals), and hospitals with PCI facilities (PCI hospitals). We used multivariable logistic regression to evaluate factors associated with clinical outcomes. Results: We included 12, 303 patients of which 9, 798 were admitted to PCI hospitals, 1, 595 to no-catheter lab hospitals, and 910 to diagnostic hospitals. Patients admitted to PCI hospitals were more frequently reviewed by a cardiologist (96%, p < 0.001) than no-catheter lab hospitals (80%) and diagnostic hospitals (74%), and more likely to receive coronary angiography (PCI hospitals (87%), diagnostic hospitals (31%), no-catheter lab hospitals (54%), p < 0.001). They also were more likely to undergo PCI (PCI hospitals (42%), diagnostic hospitals (17%), no-catheter lab hospitals (17%), p < 0.001). After adjustment, there was no significant difference in the in-hospital mortality (OR 0.76, 95% CI 0.55–1.06) or re-infarction (OR 1.28, 95% CI 0.72–2.26) in patients admitted to PCI hospitals nor in patients admitted to diagnostic hospitals (mortality (OR 1.28, 95% CI 0.72–2.26), re-infarction (OR 1.38, 95% CI 0.68–2.82)). Conclusion: There is variation in coronary angiography use between hospitals without a catheter laboratory and PCI centres, which was not associated with better in-hospital survival.