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The impact of early anticoagulant therapy on the survival of the patients with cardiac arrest caused by acute myocardial infarction
Knor, Jiří ; Pachl, Jan (advisor) ; Březina, Aleš (referee) ; Herold, Ivan (referee)
Introduction. Formation of microthrombi after successful resuscitation for out-of-hospital cardiac arrest (OHCA) may lead to the microcirculatory dysfunction and have a negative influence on patient's outcome. We performed a randomized clinical study assessing effect of intra-arrest heparin administration in OHCA patients with suspected acute myocardial infarction (AIM) on their prognosis. Method. The OHCA patients were randomized during CPR for the intra-arrest intravenous heparin 10 000 units (Group H) or for treatment without heparin (Group C). The mortality rate, favourable neurological outcome in 3 months after OHCA and the occurrence of major bleeding were registered and evaluated with statistical methods (Fisher exact test, Student t test). Results. Out of 88 randomized patients, the AIM was subsequently confirmed in 63 of them (71.6 %). There were 30 patients in group H and 33 in group C. The return of spontaneous circulation (ROSC, Group H: 40.0 %, Group C: 45.4 %, p = 0.859) and good neurological status during 3 months period after OHCA (Group H: 6.7 %, Group C: 9.1 %, p = 0.909) did not differ between groups as well as neurological outcome between subgroups of the patients who achieved the ROSC (Group H: 16.7 %, Group C: 20.0 %, p = 0.990). No major bleeding was observed. Conclusions....
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The impact of early anticoagulant therapy on the survival of the patients with cardiac arrest caused by acute myocardial infarction
Knor, Jiří ; Pachl, Jan (advisor) ; Březina, Aleš (referee) ; Herold, Ivan (referee)
Introduction. Formation of microthrombi after successful resuscitation for out-of-hospital cardiac arrest (OHCA) may lead to the microcirculatory dysfunction and have a negative influence on patient's outcome. We performed a randomized clinical study assessing effect of intra-arrest heparin administration in OHCA patients with suspected acute myocardial infarction (AIM) on their prognosis. Method. The OHCA patients were randomized during CPR for the intra-arrest intravenous heparin 10 000 units (Group H) or for treatment without heparin (Group C). The mortality rate, favourable neurological outcome in 3 months after OHCA and the occurrence of major bleeding were registered and evaluated with statistical methods (Fisher exact test, Student t test). Results. Out of 88 randomized patients, the AIM was subsequently confirmed in 63 of them (71.6 %). There were 30 patients in group H and 33 in group C. The return of spontaneous circulation (ROSC, Group H: 40.0 %, Group C: 45.4 %, p = 0.859) and good neurological status during 3 months period after OHCA (Group H: 6.7 %, Group C: 9.1 %, p = 0.909) did not differ between groups as well as neurological outcome between subgroups of the patients who achieved the ROSC (Group H: 16.7 %, Group C: 20.0 %, p = 0.990). No major bleeding was observed. Conclusions....
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