Abstract
Severe myocardial ischemia is the leading cause of arrhythmic sudden cardiac death. It is unclear, however, in which percentage of patients sudden cardiac death is triggered by ST-elevation myocardial infarction (STEMI) and whether the diagnosis of STEMI can be reliably established immediately after resuscitation from out-of-hospital sudden cardiac death. A 12-lead ECG was registered after return of spontaneous circulation after cardiac arrest. After hospital admission, further ECG, creatine kinase MB, and troponin measures; results of coronary angiograms; and autopsies were evaluated to confirm the definitive diagnosis of STEMI. Seventy-seven patients were included in our study (67% men, age 64 [14 to 93] years). STEMI was diagnosed in 44 patients. The diagnosis of myocardial infarction was confirmed in 84% of the 77 patients who survived to hospital admission. The sensitivity of the out-of-hospital ECG was 88% (95% confidence interval [CI] 74% to 96%), the specificity 69% (95% CI 51% to 83%), the positive predictive value 77% (95% CI 62% to 87%), and the negative predictive value 83% (95% CI 64% to 87%). The accuracy of the out-of-hospital ECG and that registered on admission was the same. The diagnosis of STEMI can be establ...Continue Reading
References
Aug 15, 1992·The American Journal of Cardiology·H R ArntzR Schröder
Apr 1, 1991·Journal of Internal Medicine·T Silfvast
Dec 24, 1997·Circulation·L ChamblessH Tunstall-Pedoe
Feb 2, 2000·European Heart Journal·I B MenownA A Adgey
Aug 15, 2001·Circulation·H R ArntzH P Schultheiss
Jan 17, 2002·The New England Journal of Medicine·H V HuikuriR J Myerburg
Apr 30, 2002·European Heart Journal·B KuchH Loewel
Feb 1, 2003·European Heart Journal·Frans Van de WerfUNKNOWN Task Force on the Management of Acute Myocardial Infarction of the European Society of Cardiology
Mar 26, 2003·QJM : Monthly Journal of the Association of Physicians·T J BowkerS G Thompson
May 12, 2004·Resuscitation·Wolfgang LedererMichael Baubin
Nov 24, 2004·Circulation·Rolf Schröder
Feb 24, 2006·QJM : Monthly Journal of the Association of Physicians·N Herring, D J Paterson
Mar 4, 2006·European Heart Journal·Bernard J Gersh, Elliott M Antman
Jun 17, 2006·American Heart Journal·Duane S PintoC Michael Gibson
Jun 20, 2006·American Heart Journal·Elizabeth H BradleyHarlan M Krumholz
Sep 6, 2006·Circulation·Dirk MüllerHans-Richard Arntz
Oct 24, 2007·Circulation·Kristian ThygesenNawwar Al-Attar
Citations
Sep 24, 2013·Best Practice & Research. Clinical Anaesthesiology·Nikolaos I Nikolaou, Apostolos H Christou
Sep 19, 2012·Resuscitation·M J DalyM T Harbinson
Jan 15, 2016·Herzschrittmachertherapie & Elektrophysiologie·Hans-Richard Arntz, Hans-Christian Mochmann
Jan 10, 2012·Resuscitation·Nikolaos I Nikolaou, Sotirios P Patsilinakos
Oct 20, 2015·Resuscitation·Koenraad G MonsieursUNKNOWN ERC Guidelines 2015 Writing Group
Dec 15, 2010·American Heart Journal·Ivan C RokosGregg W Stone
Apr 3, 2012·The American Journal of Cardiology·Oliver KoethUNKNOWN PREMIR Investigators
Mar 9, 2010·Air Medical Journal·Christopher P McGrathGregory A Bechtel
Jun 3, 2011·Resuscitation·Georgios SiderisPatrick Henry
Jun 21, 2011·Resuscitation·Philip Eisenburger
Jun 27, 2013·The American Journal of Cardiology·Michael C KontosMary A Peberdy
May 2, 2016·JACC. Cardiovascular Interventions·Florence DumasAlain Cariou
Sep 23, 2016·Medizinische Klinik, Intensivmedizin und Notfallmedizin·H-C Mochmann
Apr 16, 2015·European Heart Journal. Acute Cardiovascular Care·Hilde E GrootErik Lipsic
May 7, 2015·European Heart Journal. Acute Cardiovascular Care·Idrees SalamJesper Kjaergaard
Sep 22, 2017·World Journal of Cardiology·Pedro Martínez-LosasAna Viana-Tejedor
Oct 8, 2013·Journal of the American Heart Association·James M McCabePeter Ganz
Oct 7, 2017·Cardiology in Review·Michael Goldfarb, Bojan Cercek
May 3, 2014·Current Opinion in Critical Care·Guillaume GeriAlain Cariou
Oct 26, 2018·Circulation. Cardiovascular Quality and Outcomes·David C LangeTimothy D Henry
Jun 19, 2021·Journal of Arrhythmia·Martin K StilesDao Wu Wang
Jul 6, 2021·Resuscitation Plus·Amit SharmaGautam R Shroff