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The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program
Abstract Background Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of ST-segment elevation myoca...
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| Published in: | Resuscitation 2013-04, Vol.84 (4), p.460-464 |
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| creator | Maze, Ronnen Le May, Michel R Hibbert, Benjamin So, Derek Y Froeschl, Michael Glover, Chris A Dick, Alexander Marquis, Jean-Francois Blondeau, Melissa Labinaz, Marino |
| description | Abstract Background Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of ST-segment elevation myocardial infarction (STEMI). We conducted a retrospective study to determine the outcomes of patients treated with TH for OHCA in a large regionalized STEMI program. Methods Patients referred for primary PCI and TH between July 2004 and April 2011 were identified from the University of Ottawa Heart Institute STEMI database. The primary endpoint was survival to hospital discharge with sufficient neurologic recovery to enable discharge home. Results Among 2467 consecutive patients referred for primary PCI, we identified 50 patients treated with TH following OHCA. Forty-nine underwent PCI, of which 47 (96%) received a stent. Median door-to-balloon time was 113 min (IQR 91–151). Patients with good neurologic recovery were younger, mean 51 ± 9 years versus 64 ± 12, p < 0.001, and had higher baseline creatinine clearance, 70 ± 19 mL/min/1.73 m2 versus 53 ± 23 mL/min/1.73 m2 , p = 0.007. The primary endpoint of survival with sufficient neurologic recovery to enable discharge home was reached in 30 patients (60%). Four survivors required levels of assistance that precluded discharge home. Conclusions Therapeutic hypothermia in conjunction with primary PCI is associated with a favorable neurologic outcome in the majority of STEMI patients surviving OHCA. Our results suggest that TH is an important adjunctive therapy for STEMI patients suffering OHCA. |
| doi_str_mv | 10.1016/j.resuscitation.2012.08.002 |
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| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1319188049</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>1_s2_0_S030095721200398X</els_id><sourcerecordid>1319188049</sourcerecordid><originalsourceid>FETCH-LOGICAL-c438t-f6900a29d575041e0232b2fdd99be36c7d4fb3b88264231722f2de14df727da13</originalsourceid><addsrcrecordid>eNqNUV2L1DAUDeLijqt_QQK--NJ6k7RNgyDIsKsLCy7sLvgiIU1ud1L7MSbtwvx7U2YU9Mmn3MD5uPccQt4yyBmw6n2XB4xLtH42s5_GnAPjOdQ5AH9GNqyWImOlhOdkAwIgU6Xk5-RljB0AiFLJF-Scc8U5k9WGfL_fIfXD3tiZTi2ddxjMHpfZW7o77Kf1P3hDTaTGdctoZ_-EJ9SB-pEaGvAxbWF6ug9-MOFAb7fXaZ4egxlekbPW9BFfn94L8nB1eb_9kt18_Xy9_XST2ULUc9ZWCsBw5UpZQsEQuOANb51TqkFRWemKthFNXfOq4IJJzlvukBWulVw6w8QFeXfUTb4_F4yzHny02PdmxGmJmgmmWF1DoRL0wxFqwxRjwFaf9tYM9Jqv7vRf-eo1Xw21Tvkm9puT0dIM6P5wfweaAJdHAKZznzwGnYRwtOh8QDtrN_n_NPr4j47t_eit6X_gAWM3LSFlni7TMXH03Vr12jTjqWRVfxO_AKlpqZY</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1319188049</pqid></control><display><type>article</type><title>The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program</title><source>ScienceDirect Freedom Collection</source><creator>Maze, Ronnen ; Le May, Michel R ; Hibbert, Benjamin ; So, Derek Y ; Froeschl, Michael ; Glover, Chris A ; Dick, Alexander ; Marquis, Jean-Francois ; Blondeau, Melissa ; Labinaz, Marino</creator><creatorcontrib>Maze, Ronnen ; Le May, Michel R ; Hibbert, Benjamin ; So, Derek Y ; Froeschl, Michael ; Glover, Chris A ; Dick, Alexander ; Marquis, Jean-Francois ; Blondeau, Melissa ; Labinaz, Marino</creatorcontrib><description>Abstract Background Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of ST-segment elevation myocardial infarction (STEMI). We conducted a retrospective study to determine the outcomes of patients treated with TH for OHCA in a large regionalized STEMI program. Methods Patients referred for primary PCI and TH between July 2004 and April 2011 were identified from the University of Ottawa Heart Institute STEMI database. The primary endpoint was survival to hospital discharge with sufficient neurologic recovery to enable discharge home. Results Among 2467 consecutive patients referred for primary PCI, we identified 50 patients treated with TH following OHCA. Forty-nine underwent PCI, of which 47 (96%) received a stent. Median door-to-balloon time was 113 min (IQR 91–151). Patients with good neurologic recovery were younger, mean 51 ± 9 years versus 64 ± 12, p < 0.001, and had higher baseline creatinine clearance, 70 ± 19 mL/min/1.73 m2 versus 53 ± 23 mL/min/1.73 m2 , p = 0.007. The primary endpoint of survival with sufficient neurologic recovery to enable discharge home was reached in 30 patients (60%). Four survivors required levels of assistance that precluded discharge home. Conclusions Therapeutic hypothermia in conjunction with primary PCI is associated with a favorable neurologic outcome in the majority of STEMI patients surviving OHCA. Our results suggest that TH is an important adjunctive therapy for STEMI patients suffering OHCA.</description><identifier>ISSN: 0300-9572</identifier><identifier>EISSN: 1873-1570</identifier><identifier>DOI: 10.1016/j.resuscitation.2012.08.002</identifier><identifier>PMID: 22922176</identifier><language>eng</language><publisher>Ireland: Elsevier Ireland Ltd</publisher><subject>Age Factors ; Cardiac arrest ; Combined Modality Therapy ; Creatinine - analysis ; Emergency ; Female ; Humans ; Hypothermia, Induced ; Intra-Aortic Balloon Pumping ; Male ; Middle Aged ; Myocardial Infarction - mortality ; Myocardial Infarction - therapy ; Out-of-Hospital Cardiac Arrest - mortality ; Out-of-Hospital Cardiac Arrest - therapy ; Patient Discharge ; Percutaneous Coronary Intervention ; Recovery of Function ; Retrospective Studies ; ST-segment elevation myocardial infarction ; Therapeutic hypothermia ; Time-to-Treatment</subject><ispartof>Resuscitation, 2013-04, Vol.84 (4), p.460-464</ispartof><rights>Elsevier Ireland Ltd</rights><rights>2012 Elsevier Ireland Ltd</rights><rights>Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c438t-f6900a29d575041e0232b2fdd99be36c7d4fb3b88264231722f2de14df727da13</citedby><cites>FETCH-LOGICAL-c438t-f6900a29d575041e0232b2fdd99be36c7d4fb3b88264231722f2de14df727da13</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22922176$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Maze, Ronnen</creatorcontrib><creatorcontrib>Le May, Michel R</creatorcontrib><creatorcontrib>Hibbert, Benjamin</creatorcontrib><creatorcontrib>So, Derek Y</creatorcontrib><creatorcontrib>Froeschl, Michael</creatorcontrib><creatorcontrib>Glover, Chris A</creatorcontrib><creatorcontrib>Dick, Alexander</creatorcontrib><creatorcontrib>Marquis, Jean-Francois</creatorcontrib><creatorcontrib>Blondeau, Melissa</creatorcontrib><creatorcontrib>Labinaz, Marino</creatorcontrib><title>The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program</title><title>Resuscitation</title><addtitle>Resuscitation</addtitle><description>Abstract Background Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of ST-segment elevation myocardial infarction (STEMI). We conducted a retrospective study to determine the outcomes of patients treated with TH for OHCA in a large regionalized STEMI program. Methods Patients referred for primary PCI and TH between July 2004 and April 2011 were identified from the University of Ottawa Heart Institute STEMI database. The primary endpoint was survival to hospital discharge with sufficient neurologic recovery to enable discharge home. Results Among 2467 consecutive patients referred for primary PCI, we identified 50 patients treated with TH following OHCA. Forty-nine underwent PCI, of which 47 (96%) received a stent. Median door-to-balloon time was 113 min (IQR 91–151). Patients with good neurologic recovery were younger, mean 51 ± 9 years versus 64 ± 12, p < 0.001, and had higher baseline creatinine clearance, 70 ± 19 mL/min/1.73 m2 versus 53 ± 23 mL/min/1.73 m2 , p = 0.007. The primary endpoint of survival with sufficient neurologic recovery to enable discharge home was reached in 30 patients (60%). Four survivors required levels of assistance that precluded discharge home. Conclusions Therapeutic hypothermia in conjunction with primary PCI is associated with a favorable neurologic outcome in the majority of STEMI patients surviving OHCA. Our results suggest that TH is an important adjunctive therapy for STEMI patients suffering OHCA.</description><subject>Age Factors</subject><subject>Cardiac arrest</subject><subject>Combined Modality Therapy</subject><subject>Creatinine - analysis</subject><subject>Emergency</subject><subject>Female</subject><subject>Humans</subject><subject>Hypothermia, Induced</subject><subject>Intra-Aortic Balloon Pumping</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - mortality</subject><subject>Myocardial Infarction - therapy</subject><subject>Out-of-Hospital Cardiac Arrest - mortality</subject><subject>Out-of-Hospital Cardiac Arrest - therapy</subject><subject>Patient Discharge</subject><subject>Percutaneous Coronary Intervention</subject><subject>Recovery of Function</subject><subject>Retrospective Studies</subject><subject>ST-segment elevation myocardial infarction</subject><subject>Therapeutic hypothermia</subject><subject>Time-to-Treatment</subject><issn>0300-9572</issn><issn>1873-1570</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNqNUV2L1DAUDeLijqt_QQK--NJ6k7RNgyDIsKsLCy7sLvgiIU1ud1L7MSbtwvx7U2YU9Mmn3MD5uPccQt4yyBmw6n2XB4xLtH42s5_GnAPjOdQ5AH9GNqyWImOlhOdkAwIgU6Xk5-RljB0AiFLJF-Scc8U5k9WGfL_fIfXD3tiZTi2ddxjMHpfZW7o77Kf1P3hDTaTGdctoZ_-EJ9SB-pEaGvAxbWF6ug9-MOFAb7fXaZ4egxlekbPW9BFfn94L8nB1eb_9kt18_Xy9_XST2ULUc9ZWCsBw5UpZQsEQuOANb51TqkFRWemKthFNXfOq4IJJzlvukBWulVw6w8QFeXfUTb4_F4yzHny02PdmxGmJmgmmWF1DoRL0wxFqwxRjwFaf9tYM9Jqv7vRf-eo1Xw21Tvkm9puT0dIM6P5wfweaAJdHAKZznzwGnYRwtOh8QDtrN_n_NPr4j47t_eit6X_gAWM3LSFlni7TMXH03Vr12jTjqWRVfxO_AKlpqZY</recordid><startdate>20130401</startdate><enddate>20130401</enddate><creator>Maze, Ronnen</creator><creator>Le May, Michel R</creator><creator>Hibbert, Benjamin</creator><creator>So, Derek Y</creator><creator>Froeschl, Michael</creator><creator>Glover, Chris A</creator><creator>Dick, Alexander</creator><creator>Marquis, Jean-Francois</creator><creator>Blondeau, Melissa</creator><creator>Labinaz, Marino</creator><general>Elsevier Ireland Ltd</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130401</creationdate><title>The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program</title><author>Maze, Ronnen ; Le May, Michel R ; Hibbert, Benjamin ; So, Derek Y ; Froeschl, Michael ; Glover, Chris A ; Dick, Alexander ; Marquis, Jean-Francois ; Blondeau, Melissa ; Labinaz, Marino</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c438t-f6900a29d575041e0232b2fdd99be36c7d4fb3b88264231722f2de14df727da13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Age Factors</topic><topic>Cardiac arrest</topic><topic>Combined Modality Therapy</topic><topic>Creatinine - analysis</topic><topic>Emergency</topic><topic>Female</topic><topic>Humans</topic><topic>Hypothermia, Induced</topic><topic>Intra-Aortic Balloon Pumping</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - mortality</topic><topic>Myocardial Infarction - therapy</topic><topic>Out-of-Hospital Cardiac Arrest - mortality</topic><topic>Out-of-Hospital Cardiac Arrest - therapy</topic><topic>Patient Discharge</topic><topic>Percutaneous Coronary Intervention</topic><topic>Recovery of Function</topic><topic>Retrospective Studies</topic><topic>ST-segment elevation myocardial infarction</topic><topic>Therapeutic hypothermia</topic><topic>Time-to-Treatment</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Maze, Ronnen</creatorcontrib><creatorcontrib>Le May, Michel R</creatorcontrib><creatorcontrib>Hibbert, Benjamin</creatorcontrib><creatorcontrib>So, Derek Y</creatorcontrib><creatorcontrib>Froeschl, Michael</creatorcontrib><creatorcontrib>Glover, Chris A</creatorcontrib><creatorcontrib>Dick, Alexander</creatorcontrib><creatorcontrib>Marquis, Jean-Francois</creatorcontrib><creatorcontrib>Blondeau, Melissa</creatorcontrib><creatorcontrib>Labinaz, Marino</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Resuscitation</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Maze, Ronnen</au><au>Le May, Michel R</au><au>Hibbert, Benjamin</au><au>So, Derek Y</au><au>Froeschl, Michael</au><au>Glover, Chris A</au><au>Dick, Alexander</au><au>Marquis, Jean-Francois</au><au>Blondeau, Melissa</au><au>Labinaz, Marino</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program</atitle><jtitle>Resuscitation</jtitle><addtitle>Resuscitation</addtitle><date>2013-04-01</date><risdate>2013</risdate><volume>84</volume><issue>4</issue><spage>460</spage><epage>464</epage><pages>460-464</pages><issn>0300-9572</issn><eissn>1873-1570</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>Abstract Background Therapeutic hypothermia (TH) is associated with improved neurologic outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). There are currently limited data on the outcomes of patients presenting with resuscitated OHCA in the setting of ST-segment elevation myocardial infarction (STEMI). We conducted a retrospective study to determine the outcomes of patients treated with TH for OHCA in a large regionalized STEMI program. Methods Patients referred for primary PCI and TH between July 2004 and April 2011 were identified from the University of Ottawa Heart Institute STEMI database. The primary endpoint was survival to hospital discharge with sufficient neurologic recovery to enable discharge home. Results Among 2467 consecutive patients referred for primary PCI, we identified 50 patients treated with TH following OHCA. Forty-nine underwent PCI, of which 47 (96%) received a stent. Median door-to-balloon time was 113 min (IQR 91–151). Patients with good neurologic recovery were younger, mean 51 ± 9 years versus 64 ± 12, p < 0.001, and had higher baseline creatinine clearance, 70 ± 19 mL/min/1.73 m2 versus 53 ± 23 mL/min/1.73 m2 , p = 0.007. The primary endpoint of survival with sufficient neurologic recovery to enable discharge home was reached in 30 patients (60%). Four survivors required levels of assistance that precluded discharge home. Conclusions Therapeutic hypothermia in conjunction with primary PCI is associated with a favorable neurologic outcome in the majority of STEMI patients surviving OHCA. Our results suggest that TH is an important adjunctive therapy for STEMI patients suffering OHCA.</abstract><cop>Ireland</cop><pub>Elsevier Ireland Ltd</pub><pmid>22922176</pmid><doi>10.1016/j.resuscitation.2012.08.002</doi><tpages>5</tpages></addata></record> |
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| subjects | Age Factors Cardiac arrest Combined Modality Therapy Creatinine - analysis Emergency Female Humans Hypothermia, Induced Intra-Aortic Balloon Pumping Male Middle Aged Myocardial Infarction - mortality Myocardial Infarction - therapy Out-of-Hospital Cardiac Arrest - mortality Out-of-Hospital Cardiac Arrest - therapy Patient Discharge Percutaneous Coronary Intervention Recovery of Function Retrospective Studies ST-segment elevation myocardial infarction Therapeutic hypothermia Time-to-Treatment |
| title | The impact of therapeutic hypothermia as adjunctive therapy in a regional primary PCI program |
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