The following is a summary of “Incidence and Long‐Term Outcomes of Acute Myocardial Infarction Among Survivors of Out‐of‐Hospital Cardiac Arrest,” published in the December 2023 issue of Cardiology by Ho et al.
In the context of improving long-term survival rates following out-of-hospital cardiac arrest (OHCA), the associated risk of subsequent acute myocardial infarction (AMI) remains inadequately elucidated. This retrospective cohort study comprised 882 OHCA survivors between 2010 and 2019, aiming to ascertain the incidence, predictors, and enduring consequences of AMI in this population.
OHCA survivors exhibited a heightened risk of subsequent AMI compared to an age- and sex-matched general population (standardized incidence ratio, 4.64 [95% CI, 3.52–6.01]). Age-specific risks were significantly elevated for both men (standardized incidence ratio, 3.29 [95% CI, 2.39–4.42]) and women (standardized incidence ratio, 6.15 [95% CI, 3.27–10.52]). At 3, 5, and end of follow-up years, 7.2%, 8.3%, and 14.3% of OHCA survivors experienced subsequent AMI, respectively. The age at OHCA and a history of prior AMI were associated with an increased risk of subsequent AMI, while an initial shockable rhythm did not show a significant correlation. Moreover, OHCA survivors with subsequent AMI faced a higher risk of mortality (hazard ratio, 1.58 [95% CI, 1.12–2.22]) than those without.
These findings underscore the amplified vulnerability of OHCA survivors to subsequent AMI, highlighting the significance of factors such as age and past AMI history in predicting this risk. The association between subsequent AMI and increased mortality emphasizes the imperative for preventive measures, emphasizing the potential benefits of cardiovascular risk factor control and revascularization strategies for improving outcomes in OHCA survivors with a cardiac pathogenic origin.