GLORIA

GEOMAR Library Ocean Research Information Access

X

Your email was sent successfully. Check your inbox.

An error occurred while sending the email. Please try again.

Proceed reservation?

Export
  • 1
    Online Resource
    Online Resource
    Identifying Patients at Risk for Prehospital Sudden Cardiac Arrest at the Early Phase of Myocardial Infarction : The e-MUST Study (Evaluation en Médecine d’Urgence des Stratégies Thérapeutiques des infarctus du myocarde)
    Ovid Technologies (Wolters Kluwer Health) ; 2016
    In:  Circulation Vol. 134, No. 25 ( 2016-12-20), p. 2074-2083
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 134, No. 25 ( 2016-12-20), p. 2074-2083
    Abstract: In-hospital mortality of ST-segment–elevation myocardial infarction (STEMI) has decreased drastically. In contrast, prehospital mortality from sudden cardiac arrest (SCA) remains high and difficult to reduce. Identification of the patients with STEMI at higher risk for prehospital SCA could facilitate rapid triage and intervention in the field. Methods: Using a prospective, population-based study evaluating all patients with STEMI managed by emergency medical services in the greater Paris area (11.7 million inhabitants) between 2006 and 2010, we identified characteristics associated with an increased risk of prehospital SCA and used these variables to build an SCA prediction score, which we validated internally and externally. Results: In the overall STEMI population (n=8112; median age, 60 years; 78% male), SCA occurred in 452 patients (5.6%). In multivariate analysis, younger age, absence of obesity, absence of diabetes mellitus, shortness of breath, and a short delay between pain onset and call to emergency medical services were the main predictors of SCA. A score built from these variables predicted SCA, with the risk increasing 2-fold in patients with a score between 10 and 19, 4-fold in those with a score between 20 and 29, and 〉 18-fold in patients with a score ≥30 compared with those with scores 〈 10. The SCA rate was 28.9% in patients with a score ≥30 compared with 1.6% in patients with a score ≤9 ( P for trend 〈 0.001). The area under the curve values were 0.7033 in the internal validation sample and 0.6031 in the external validation sample. Sensitivity and specificity varied between 96.9% and 10.5% for scores ≥10 and between 18.0% and 97.6% for scores ≥30, with scores between 20 and 29 achieving the best sensitivity and specificity (65.4% and 62.6%, respectively). Conclusions: At the early phase of STEMI, the risk of prehospital SCA can be determined through a simple score of 5 routinely assessed predictors. This score might help optimize the dispatching and management of patients with STEMI by emergency medical services.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/CIRCULATIONAHA.116.022954
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2016
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 2
    Online Resource
    Online Resource
    Incidence, Mortality, and Outcome-Predictors of Sudden Cardiac Arrest Complicating Myocardial Infarction Prior to Hospital Admission
    Ovid Technologies (Wolters Kluwer Health) ; 2019
    In:  Circulation: Cardiovascular Interventions Vol. 12, No. 1 ( 2019-01)
    Details
    In: Circulation: Cardiovascular Interventions, Ovid Technologies (Wolters Kluwer Health), Vol. 12, No. 1 ( 2019-01)
    Abstract: Mortality of ST-segment–elevation myocardial infarction (STEMI) decreased drastically, mainly through reduction in inhospital mortality. Prehospital sudden cardiac arrest (SCA) became one of the most feared complications. We assessed the incidence, outcome, and prognosis’ predictors of prehospital SCA occurring after emergency medical services (EMS) arrival. Methods and Results: Data were taken between 2006 and 2014 from the e-MUST study (Evaluation en Médecine d’Urgence des Strategies Thérapeutiques des infarctus du myocarde) that enrolls all STEMI managed by EMS in the Greater Paris Area, including those dead before hospital admission. Among 13 253 STEMI patients analyzed, 749 (5.6%) presented EMS-witnessed prehospital SCA. Younger age, absence of cardiovascular risk factors, symptoms of heart failure, extensive STEMI, and short pain onset-to-call and call-to-EMS arrival delays were independently associated with increased SCA risk. Mortality rate at hospital discharge was 4.0% in the nonSCA group versus 37.7% in the SCA group ( P 〈 0.001); 26.8% of deaths occurred before hospital admission. Factors associated with increased mortality after SCA were age, heart failure, and extensive STEMI, while male sex and cardiovascular risk factors were associated with decreased mortality. Among patients admitted alive, PCI was the most important mortality-reduction predictor (odds ratio, 0.40; 95% CI, 0.25–0.63; P 〈 0.0001). Conclusions: More than 1 of 20 STEMI presents prehospital SCA after EMS arrival. SCA occurrence is associated with a 10-fold higher mortality at hospital discharge compared with STEMI without SCA. PCI is the strongest survival predictor, leading to a twice-lower mortality. This highlights the persistently dramatic impact of SCA on STEMI and the major importance of PCI in this setting.
    Type of Medium: Online Resource
    ISSN: 1941-7640 , 1941-7632
    URL: Article
    DOI: 10.1161/CIRCINTERVENTIONS.118.007081
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2019
    detail.hit.zdb_id: 2450801-9
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 3
    Online Resource
    Online Resource
    Characteristics and Outcomes of Sudden Cardiac Arrest During Sports in Women
    Ovid Technologies (Wolters Kluwer Health) ; 2013
    In:  Circulation: Arrhythmia and Electrophysiology Vol. 6, No. 6 ( 2013-12), p. 1185-1191
    Details
    In: Circulation: Arrhythmia and Electrophysiology, Ovid Technologies (Wolters Kluwer Health), Vol. 6, No. 6 ( 2013-12), p. 1185-1191
    Abstract: No specific data are available on characteristics and outcome of sudden cardiac death (SCD) during sport activities among women in the general population. Methods and Results— From a prospective 5-year national survey, involving 820 subjects 10 to 75 years old who presented with SCD (resuscitated or not) during competitive or recreational sport activities, 43 (5.2%) such events occurred in women, principally during jogging, cycling, and swimming. The level of activity at the time of SCD was moderate to vigorous in 35 cases (81.4%). The overall incidence of sport-related SCD, among 15- to 75-year-old women, was estimated as 0.59 (95% confidence interval [CI], 0.39–0.79) to 2.17 (95% CI, 1.38–2.96) per year per million female sports participants for the 80th and 20th percentiles of reporting districts, respectively. Compared with men, the incidence of SCDs in women was dramatically lower, particularly in the 45- to 54-year range (relative risk, 0.033; 95% CI, 0.015–0.075). Despite similar circumstances of occurrence, survival at hospital admission (46.5%; 95% CI, 31.0–60.0) was significantly higher than that for men (30.0%; 95% CI, 26.8–33.2; P =0.02), although this did not reach statistical significance for hospital discharge. Favorable neurological outcomes were similar (80%). Cause of death seemed less likely to be associated with structural heart disease in women compared with men (58.3% versus 95.8%; P =0.003). Conclusions— Sports-related SCDs in women participants seems dramatically less common (up to 30-fold less frequent) compared with men. Our results also suggest a higher likelihood of successful resuscitation as well as less frequency of structural heart disease in women compared with men.
    Type of Medium: Online Resource
    ISSN: 1941-3149 , 1941-3084
    URL: Article
    DOI: 10.1161/CIRCEP.113.000651
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2013
    detail.hit.zdb_id: 2425487-3
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 4
    Online Resource
    Online Resource
    Characteristics and outcomes of out-of-hospital sudden cardiac arrest according to the time of occurrence
    Elsevier BV ; 2017
    In:  Resuscitation Vol. 116 ( 2017-07), p. 16-21
    Details
    In: Resuscitation, Elsevier BV, Vol. 116 ( 2017-07), p. 16-21
    Type of Medium: Online Resource
    ISSN: 0300-9572
    URL: Article
    DOI: 10.1016/j.resuscitation.2017.04.024
    Language: English
    Publisher: Elsevier BV
    Publication Date: 2017
    detail.hit.zdb_id: 2010733-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 5
    Online Resource
    Online Resource
    Abstract 13027: Risk of Sudden Cardiac Arrest According to the Time of STEMI Occurrence: the e-MUST Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: Introduction: STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main mode of death. The risk of out-of-hospital SCA according to the timing of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA, prior to hospital admission, differs according to the timing of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on all STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send, in the field, an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed the rate of SCA, prior to hospital admission, according to the timing of STEMI occurrence (4 hours-time intervals starting at midnight). Results: Among the 8,112 STEMI patients enrolled (mean age (SD) 61.6 (14.3) years, 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant circadian change in the rate of SCA per STEMI, with a progressive increase between 4am and 8pm, followed by a decrease between 8pm and 4am (P=0.0009). The peak rate of SCA per STEMI occurred in the 4pm-8pm time interval (7.7%), while the lowest rate was seen between 4am and 8am (4.2%) (Figure). Conclusions: The risk of STEMI-related SCA is almost 2-fold higher in STEMI occurring in the late afternoon hours. A better understanding of patients’ characteristics, circumstances of occurrence, and pre-hospital care is needed to eventually reduce the risk of SCA promptly after STEMI diagnosis in the field.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.13027
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
  • 6
    Online Resource
    Online Resource
    Abstract 19529: Risk of Sudden Cardiac Arrest According to the Month of STEMI Occurrence: The e-MUST Study
    Ovid Technologies (Wolters Kluwer Health) ; 2015
    In:  Circulation Vol. 132, No. suppl_3 ( 2015-11-10)
    Details
    In: Circulation, Ovid Technologies (Wolters Kluwer Health), Vol. 132, No. suppl_3 ( 2015-11-10)
    Abstract: STEMI mortality decreased drastically during the last decades, and out-of-hospital sudden cardiac arrest (SCA) has become its main cause of death. The risk of SCA according to the month of STEMI occurrence has not been assessed. Hypothesis: The risk of SCA varies according to the month of STEMI occurrence. Methods: Data were taken from a prospective pre-hospital study (e-MUST study) on STEMI patients managed by emergency medical services in Paris and its suburbs between January 2006 and December 2010. In this area, emergency calls are routed to the closest dispatch center and regulated by physicians who send an ambulance with a physician on board in case of suspected acute myocardial infarction. Pre-hospital EKGs are obtained for all patients and those presenting STEMI are included in the study. We assessed and compared the rate of SCA according to the month of STEMI occurrence. Results: Among the 8112 STEMI patients enrolled (mean age (SD) 61.6years (14.3), 78% males), 452 patients (5.6%) developed out-of-hospital SCA. We observed significant temporal changes in the rate of SCA per STEMI over the year. The peak rate of SCA per STEMI occurred in June (8.7%), while the lowest rate was in December (3.45%) (Figure). Conclusions: The risk of SCA varies significantly according to the month of STEMI occurrence, with STEMI occurring in June being at the highest risk for SCA while those occurring in December have the lowest risk. A better understanding of the pathophysiological mechanisms of this difference is needed to eventually reduce the risk of out-of-hospital SCA after STEMI diagnosis.
    Type of Medium: Online Resource
    ISSN: 0009-7322 , 1524-4539
    URL: Article
    DOI: 10.1161/circ.132.suppl_3.19529
    Language: English
    Publisher: Ovid Technologies (Wolters Kluwer Health)
    Publication Date: 2015
    detail.hit.zdb_id: 1466401-X
    Location Call Number Limitation Availability
    BibTip Others were also interested in ...
    Online Resource
Close ⊗
This website uses cookies and the analysis tool Matomo. More information can be found here...