Survival of resuscitated cardiac arrest patients with ST-elevation myocardial infarction (STEMI) conveyed directly to a Heart Attack Centre by ambulance clinicians

© Gary Wilson/ Pre-hospital Research Forum

Resuscitation. Available online 19 September 2013

This study reports survival outcomes for patients resuscitated from out-of-hospital cardiac arrest (OHCA) subsequent to ST-elevation myocardial infarction (STEMI), and who were conveyed directly by ambulance clinicians to a specialist Heart Attack Centre for expert cardiology assessment, angiography and possible percutaneous coronary intervention (PCI).

Methods
This is a retrospective descriptive review of data sourced from the London Ambulance Service’s OHCA registry over a one-year period.

Results

The authors observed excellent survival rates for our cohort of patients with 66% of patients surviving to be discharged from hospital, the majority of whom were still alive after one year. Those who survived tended to be younger, to have had a witnessed arrest in a public place with an initial cardiac rhythm of VF/VT, and to have been transported to the specialist centre more quickly than those who did not.

Conclusion
A system allowing ambulance clinicians to autonomously convey OHCA STEMI patients who achieve a return of spontaneous circulation directly to a Heart Attack Centre is highly effective and yields excellent survival outcomes.

http://www.sciencedirect.com/science/article/pii/S0300957213007326

Should we be establishing heart attack centres, similar to stroke centres, to ensure all patients with heart attacks, including those in cardiac arrest, receive optimum treatment, such as cardiologist review, angiography and PCI, or at least ensuring that our patients are conveyed to hospitals with these facilities?
Achieving a rate of 66% for patients surviving to discharge, with the majority of whom were still alive after one year, could suggest that that this is a good idea.