Myocardial infarction is a frequent cause of exercise-related resuscitated out-of-hospital cardiac arrest in a general non-athletic population

Helle Søholm; Jesper Kjaergaard; Jakob Hartvig Thomsen; John Bro-Jeppesen; Freddy K Lippert; Lars Køber; Michael Wanscher; Christian Hassager

doi:10.1016/j.resuscitation.2014.06.033

Myocardial infarction is a frequent cause of exercise-related resuscitated out-of-hospital cardiac arrest in a general non-athletic population

Helle Søholm, Jesper Kjaergaard, Jakob Hartvig Thomsen, John Bro-Jeppesen, Freddy K Lippert, Lars Køber, Michael Wanscher, Christian Hassager

Institut for Klinisk Medicin

6 Citationer (Scopus)

Abstract

Background: Performing exercise is shown to prevent cardiovascular disease, but the risk of an out-of-hospital cardiac arrest (OHCA) is temporarily increased during strenuous activity. We examined the etiology and outcome after successfully resuscitated OHCA during exercise in a general non-athletic population. Methods: Consecutive patients with OHCA were admitted with return of spontaneous circulation (ROSC) or on-going resuscitation at hospital arrival (2002-2011). Patient charts were reviewed for post-resuscitation data. Exercise was defined as moderate/vigorous physical activity. Results: A total of 1393 OHCA-patients were included with 91(7%) arrests occurring during exercise. Exercise-related OHCA-patients were younger (60. ±. 13 vs. 65. ±. 15, p<. 0.001) and predominantly male (96% vs. 69%, p<. 0.001). The arrest was more frequently witnessed (94% vs. 86%, p=. 0.02), bystander CPR was more often performed (88% vs. 54%, p<. 0.001), time to ROSC was shorter (12. min (IQR: 5-19) vs. 15 (9-22), p=. 0.007) and the primary rhythm was more frequently shock-able (91% vs. 49%, p<. 0.001) compared to non-exercise patients. Cardiac etiology was the predominant cause of OHCA in both exercise and non-exercise patients (97% vs. 80%, p<. 0.001) and acute coronary syndrome was more frequent among exercise patients (59% vs. 38%, p<. 0.001). One-year mortality was 25% vs. 65% (. p<. 0.001), and exercise was even after adjustment associated with a significantly lower mortality (HR. =. 0.40 (95%CI: 0.23-0.72), p=. 0.002). Conclusions: OHCA occurring during exercise was associated with a significantly lower mortality in successfully resuscitated patients even after adjusting for confounding factors. Acute coronary syndrome was more common among exercise-related cardiac arrest patients.

Originalsprog	Engelsk
Tidsskrift	Resuscitation
Vol/bind	85
Udgave nummer	11
Sider (fra-til)	1612-1618
Antal sider	7
ISSN	0300-9572
DOI	https://doi.org/10.1016/j.resuscitation.2014.06.033
Status	Udgivet - 1 nov. 2014

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10.1016/j.resuscitation.2014.06.033

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title = "Myocardial infarction is a frequent cause of exercise-related resuscitated out-of-hospital cardiac arrest in a general non-athletic population",

abstract = "Background: Performing exercise is shown to prevent cardiovascular disease, but the risk of an out-of-hospital cardiac arrest (OHCA) is temporarily increased during strenuous activity. We examined the etiology and outcome after successfully resuscitated OHCA during exercise in a general non-athletic population. Methods: Consecutive patients with OHCA were admitted with return of spontaneous circulation (ROSC) or on-going resuscitation at hospital arrival (2002-2011). Patient charts were reviewed for post-resuscitation data. Exercise was defined as moderate/vigorous physical activity. Results: A total of 1393 OHCA-patients were included with 91(7%) arrests occurring during exercise. Exercise-related OHCA-patients were younger (60. ±. 13 vs. 65. ±. 15, p<. 0.001) and predominantly male (96% vs. 69%, p<. 0.001). The arrest was more frequently witnessed (94% vs. 86%, p=. 0.02), bystander CPR was more often performed (88% vs. 54%, p<. 0.001), time to ROSC was shorter (12. min (IQR: 5-19) vs. 15 (9-22), p=. 0.007) and the primary rhythm was more frequently shock-able (91% vs. 49%, p<. 0.001) compared to non-exercise patients. Cardiac etiology was the predominant cause of OHCA in both exercise and non-exercise patients (97% vs. 80%, p<. 0.001) and acute coronary syndrome was more frequent among exercise patients (59% vs. 38%, p<. 0.001). One-year mortality was 25% vs. 65% (. p<. 0.001), and exercise was even after adjustment associated with a significantly lower mortality (HR. =. 0.40 (95%CI: 0.23-0.72), p=. 0.002). Conclusions: OHCA occurring during exercise was associated with a significantly lower mortality in successfully resuscitated patients even after adjusting for confounding factors. Acute coronary syndrome was more common among exercise-related cardiac arrest patients.",

author = "Helle S{\o}holm and Jesper Kjaergaard and Thomsen, {Jakob Hartvig} and John Bro-Jeppesen and Lippert, {Freddy K} and Lars K{\o}ber and Michael Wanscher and Christian Hassager",

year = "2014",

month = nov,

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doi = "10.1016/j.resuscitation.2014.06.033",

language = "English",

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pages = "1612--1618",

journal = "Resuscitation",

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TY - JOUR

T1 - Myocardial infarction is a frequent cause of exercise-related resuscitated out-of-hospital cardiac arrest in a general non-athletic population

AU - Søholm, Helle

AU - Kjaergaard, Jesper

AU - Thomsen, Jakob Hartvig

AU - Bro-Jeppesen, John

AU - Lippert, Freddy K

AU - Køber, Lars

AU - Wanscher, Michael

AU - Hassager, Christian

PY - 2014/11/1

Y1 - 2014/11/1

N2 - Background: Performing exercise is shown to prevent cardiovascular disease, but the risk of an out-of-hospital cardiac arrest (OHCA) is temporarily increased during strenuous activity. We examined the etiology and outcome after successfully resuscitated OHCA during exercise in a general non-athletic population. Methods: Consecutive patients with OHCA were admitted with return of spontaneous circulation (ROSC) or on-going resuscitation at hospital arrival (2002-2011). Patient charts were reviewed for post-resuscitation data. Exercise was defined as moderate/vigorous physical activity. Results: A total of 1393 OHCA-patients were included with 91(7%) arrests occurring during exercise. Exercise-related OHCA-patients were younger (60. ±. 13 vs. 65. ±. 15, p<. 0.001) and predominantly male (96% vs. 69%, p<. 0.001). The arrest was more frequently witnessed (94% vs. 86%, p=. 0.02), bystander CPR was more often performed (88% vs. 54%, p<. 0.001), time to ROSC was shorter (12. min (IQR: 5-19) vs. 15 (9-22), p=. 0.007) and the primary rhythm was more frequently shock-able (91% vs. 49%, p<. 0.001) compared to non-exercise patients. Cardiac etiology was the predominant cause of OHCA in both exercise and non-exercise patients (97% vs. 80%, p<. 0.001) and acute coronary syndrome was more frequent among exercise patients (59% vs. 38%, p<. 0.001). One-year mortality was 25% vs. 65% (. p<. 0.001), and exercise was even after adjustment associated with a significantly lower mortality (HR. =. 0.40 (95%CI: 0.23-0.72), p=. 0.002). Conclusions: OHCA occurring during exercise was associated with a significantly lower mortality in successfully resuscitated patients even after adjusting for confounding factors. Acute coronary syndrome was more common among exercise-related cardiac arrest patients.

AB - Background: Performing exercise is shown to prevent cardiovascular disease, but the risk of an out-of-hospital cardiac arrest (OHCA) is temporarily increased during strenuous activity. We examined the etiology and outcome after successfully resuscitated OHCA during exercise in a general non-athletic population. Methods: Consecutive patients with OHCA were admitted with return of spontaneous circulation (ROSC) or on-going resuscitation at hospital arrival (2002-2011). Patient charts were reviewed for post-resuscitation data. Exercise was defined as moderate/vigorous physical activity. Results: A total of 1393 OHCA-patients were included with 91(7%) arrests occurring during exercise. Exercise-related OHCA-patients were younger (60. ±. 13 vs. 65. ±. 15, p<. 0.001) and predominantly male (96% vs. 69%, p<. 0.001). The arrest was more frequently witnessed (94% vs. 86%, p=. 0.02), bystander CPR was more often performed (88% vs. 54%, p<. 0.001), time to ROSC was shorter (12. min (IQR: 5-19) vs. 15 (9-22), p=. 0.007) and the primary rhythm was more frequently shock-able (91% vs. 49%, p<. 0.001) compared to non-exercise patients. Cardiac etiology was the predominant cause of OHCA in both exercise and non-exercise patients (97% vs. 80%, p<. 0.001) and acute coronary syndrome was more frequent among exercise patients (59% vs. 38%, p<. 0.001). One-year mortality was 25% vs. 65% (. p<. 0.001), and exercise was even after adjustment associated with a significantly lower mortality (HR. =. 0.40 (95%CI: 0.23-0.72), p=. 0.002). Conclusions: OHCA occurring during exercise was associated with a significantly lower mortality in successfully resuscitated patients even after adjusting for confounding factors. Acute coronary syndrome was more common among exercise-related cardiac arrest patients.

U2 - 10.1016/j.resuscitation.2014.06.033

DO - 10.1016/j.resuscitation.2014.06.033

M3 - Journal article

C2 - 25047569

SN - 0300-9572

VL - 85

SP - 1612

EP - 1618

JO - Resuscitation

JF - Resuscitation

IS - 11

ER -

Myocardial infarction is a frequent cause of exercise-related resuscitated out-of-hospital cardiac arrest in a general non-athletic population

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