TUESDAY, June 1 (HealthDay News) -- Both hyperoxia after cardiopulmonary resuscitation (CPR) and non-adherence to recommended timing of interventions after ST-elevation myocardial infarction (STEMI) result in significant increases in mortality, according to two studies published in the June 2 issue of the Journal of the American Medical Association.
J. Hope Kilgannon, M.D., of Cooper University Hospital in Camden, N.J., and colleagues studied a cohort of 6,326 intensive care unit patients after cardiac arrest. They found that the 18 percent of patients who were hyperoxic (PaO2 of 300 mm Hg or greater) after CPR had a significantly higher in-hospital mortality rate (63 percent) than those who were hypoxic (57 percent) or normoxic (45 percent).
Laurie Lambert, Ph.D., of the Quebec Healthcare Assessment Agency in Montreal, and colleagues systematically evaluated a large population of patients with STEMI. They found that reperfusion procedures delivered after the recommended cutoff time (30 minutes for fibrinolysis, 90 minutes for primary percutaneous coronary intervention) were associated with significantly increased 30-day mortality and a significantly increased risk of the composite of death or readmission for heart attack or heart failure at one year.
"The study findings suggest that time to reperfusion rather than treatment strategy may be more important in terms of outcomes and can help inform clinical decision making to optimize care for patients with acute myocardial infarction presenting to hospitals in Quebec," Lambert and colleagues conclude.
One author in each study disclosed financial ties to medical device and medical technology companies.
Abstract - Kilgannon
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Abstract - Lambert
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