ST-segment elevation is associated with a higher risk of cardiac arrest in patients with acute coronary syndromes

Type of funding sources: None.

Cardiac arrest is a feared complication of cardiovascular disease, even in inpatient context, and requires swift and precise management to avoid increasing morbimortality. Identifying which patients are at greater risk could potentially improve outcomes.

We aim to identify if ST-segment elevation is related with a higher incidence of intra-hospital cardiac arrest.

We analysed a population of 940 patients (C) admitted with ACS and divided them into two groups: those who had a myocardial infarction (MI) with ST-segment elevation on ECG (C1), and those who had no ST-segment elevation (C2), which included those with MI with no ST-segment elevation, undetermined location MI and unstable angina. We then compared the incidence of cardiac arrest between both groups. Age, sex, personal history of smoking, hypertension, dyslipidaemia, diabetes mellitus, and previous stroke/TIA and myocardial infarction were also documented.

C1 was comprised of 379 patients (40,3% of the population). When comparing age, sex and prevalence of hypertension, dyslipidaemia, diabetes, and previous stroke/TIA or myocardial infarction between the groups, there were no relevant differences and no impact regarding risk of cardiac arrest was documented. Nonetheless, C1 had a significantly higher incidence of intra-hospital cardiac arrest (6,1% vs 0,5%, p=0,0001; odds ratio: 12,017, 95% CI [3,582;40,316]) than C2.

Patients with ST-segment elevation on admission have a 12-time higher risk of intra-hospital cardiac arrest than other ACS and thus may require more careful and regular monitoring.