Out-of-hospital cardiac arrest in patients treated for ST-elevation acute myocardial infarction: Incidence, clinical features, and prognosis based on population-level data from Hungary

Abstract Aim Out-of-hospital cardiac arrest (OHCA) is a severe complication of myocardial infarction. Literature data on the incidence of OHCA are inconsistent, and population-level data are incomplete. Methods Based on the Hungarian Myocardial Infarction Registry, the incidence of OHCA and its 30-day and 1-year mortality, as well as the significance of factors influencing the course of the disease in 28,083 ST-elevation myocardial infarction patients, were investigated using multivariable regression models. Results Of the 28,083 STEMI patients, 1535 (5.5%) had OHCA, which was more likely to occur in men. The long-term incidence of OHCA did not change significantly; no significant seasonality was found either. However, the daily distribution of cases showed that most OHCA patients were admitted to the hospital around 8 p.m. The occurrence of OHCA significantly worsened patients' prognoses; both 30-day and 1-year mortalities were considerably higher in the OHCA group than in the control group (46% vs 11.6%, 53.2% vs 18.7%, p Conclusion Multivariable analysis confirmed the independent prognostic significance of age, catheter intervention during the index hospitalisation, OHCA, and cardiogenic shock.