Thrombolytic therapy vs primary percutaneous intervention after ventricular fibrillation cardiac arrest due to acute ST-segment elevation myocardial infarction and its effect on outcome

Richling, Nina; Herkner, Harald; Holzer, Michael; Riedmueller, Eva; Sterz, Fritz; Schreiber, Wolfgang

doi:10.1016/j.ajem.2006.10.014

« Previous Next »American Journal of Emergency Medicine
Volume 25, Issue 5 , Pages 545-550, June 2007

Thrombolytic therapy vs primary percutaneous intervention after ventricular fibrillation cardiac arrest due to acute ST-segment elevation myocardial infarction and its effect on outcome

Department of Emergency Medicine, Medical University of Vienna, 1090 Vienna, Austria

Received 8 September 2006; received in revised form 19 October 2006; accepted 24 October 2006.

Abstract

The aim of this study was to evaluate the effect of thrombolytic therapy on neurologic outcome and mortality in patients after cardiac arrest due to acute ST-elevation myocardial infarction and to compare this with those in patients treated with primary percutaneous coronary intervention (PCI).

We retrospectively examined patients after they had ventricular fibrillation cardiac arrests. To assess the effect of thrombolysis and PCI on outcome, we used odds ratios and their 95% confidence intervals and logistic regression modeling.

Thrombolysis was applied in 101 patients (69%) and PCI in 46 patients (31%). More patients who received thrombolysis had favorable functional neurologic recovery (cerebral performance category 1 and 2) and survived to 6 months compared with patients with primary PCI (P = .38 and P = .13, respectively).

In patients with cardiac arrest due to ST-elevation myocardial infarction, it may be acceptable to use thrombolysis as a reperfusion strategy. This applies especially in hospitals where immediate PCI is not available.