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Left-sided valvular heart disease and survival in out-of-hospital cardiac arrest: a nationwide registry-based study.
Department of Molecular and Clinical Medicine, University of Gothenburg, Institute of Medicine, Gothenburg, Sweden.
Mount Sinai Heart, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Department of Molecular and Clinical Medicine, University of Gothenburg, Institute of Medicine, Gothenburg, Sweden; Department of Cardiology, The Sahlgrenska University Hospital, Gothenburg, Sweden; The Swedish Cardiopulmonary Resuscitation Registry, Centre of Registries, Västra Götaland, Gothenburg, Sweden.
Department of Molecular and Clinical Medicine, University of Gothenburg, Institute of Medicine, Gothenburg, Sweden; Department of Cardiology, The Sahlgrenska University Hospital, Gothenburg, Sweden; The Swedish Cardiopulmonary Resuscitation Registry, Centre of Registries, Västra Götaland, Gothenburg, Sweden.
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2023 (English)In: Scientific Reports, E-ISSN 2045-2322, Vol. 13, article id 12662Article in journal (Refereed) Published
Abstract [en]

Survival in left-sided valvular heart disease (VHD; aortic stenosis [AS], aortic regurgitation [AR], mitral stenosis [MS], mitral regurgitation [MR]) in out-of-hospital cardiac arrest (OHCA) is unknown. We studied all cases of OHCA in the Swedish Registry for Cardiopulmonary Resuscitation. All degrees of VHD, diagnosed prior to OHCA, were included. Association between VHD and survival was studied using logistic regression, gradient boosting and Cox regression. We studied time to cardiac arrest, comorbidities, survival, and cerebral performance category (CPC) score. We included 55,615 patients; 1948 with AS (3,5%), 384 AR (0,7%), 17 MS (0,03%), and 704 with MR (1,3%). Patients with MS were not described due to low case number. Time from VHD diagnosis to cardiac arrest was 3.7 years in AS, 4.5 years in AR and 4.1 years in MR. ROSC occurred in 28% with AS, 33% with AR, 36% with MR and 35% without VHD. Survival at 30 days was 5.2%, 10.4%, 9.2%, 11.4% in AS, AR, MR and without VHD, respectively. There were no survivors in people with AS presenting with asystole or PEA. CPC scores did not differ in those with VHD compared with no VHD. Odds ratio (OR) for MR and AR showed no difference in survival, while AS displayed OR 0.58 (95% CI 0.46-0.72), vs no VHD. AS is associated with halved survival in OHCA, while AR and MR do not affect survival. Survivors with AS have neurological outcomes comparable to patients without VHD.

Place, publisher, year, edition, pages
2023. Vol. 13, article id 12662
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Cardiac and Cardiovascular Systems
Research subject
The Human Perspective in Care
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URN: urn:nbn:se:hb:diva-31217DOI: 10.1038/s41598-023-39570-zPubMedID: 37542095OAI: oai:DiVA.org:hb-31217DiVA, id: diva2:1826228
Available from: 2024-01-11 Created: 2024-01-11 Last updated: 2024-01-19Bibliographically approved

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