Clinical characteristics, management, and outcomes of acute myocardial infarction-related cardiogenic shock patients with and without out-of-hospital cardiac arrest: a Gulf region registry analysis
Author Department
Cardiology; Medicine
Document Type
Article, Peer-reviewed
Publication Date
9-2025
Abstract
Background: Out-of-hospital cardiac arrest (OHCA) in the setting of acute myocardial infarction-related cardiogenic shock (AMI-CS) represents a particularly high-risk subgroup. The Cardiac Arrest Hospital Prognosis (CAHP) score is a prognostic tool used in post-arrest care; however, its utility in predicting in-hospital mortality among OHCA survivors with AMI-CS in the Gulf region remains unclear. This study assessed differences in clinical characteristics and outcomes between AMI-CS patients with and without OHCA and evaluated the discriminative ability of the CAHP score.
Methods: A retrospective analysis was performed using data from the Gulf-CS registry, including 1513 patients diagnosed with AMI-CS from 2020 to 2022. Patients were stratified by the presence of OHCA at presentation.
Results: Among the cohort, 138 patients (9.1 %) experienced OHCA and survived to hospital presentation. These patients were younger and with fewer comorbidities. ST-elevation myocardial infarction (STEMI) was significantly more common in the OHCA group (89.1 % vs. 72.3 %, P < 0.001). Despite the severity of OHCA, in-hospital mortality was lower in this group compared to those without arrest (34.8 % vs. 46.5 %, P = 0.009), although they had a higher incidence of cerebrovascular accidents (9.4 % vs. 5.2 %, P = 0.042). The CAHP score was strongly associated with in-hospital mortality (OR: 1.067, P < 0.001), with the highest risk observed in those with scores >200 (64.6 % mortality).
Conclusion: Among AMI-CS patients, those with OHCA who survive to hospital presentation exhibit lower in-hospital mortality. The CAHP score demonstrated good discriminative ability for in-hospital mortality in this population.
Keywords: Acute myocardial infarction; CAHP score; Cardiogenic shock; Out-of-hospital cardiac arrest.
Recommended Citation
Daoulah A, Kanbr O, Elmahrouk A, Jarallah MA, Yousif N, Jamjoom A, Iqbal MN, Arafat AA, Damon K, Al-Bawardy R, Panduranga P, Arabi A, Alamro B, Alharbi W, Ross EM, Ghani MA, Lotfi A, Marsh V, Seraj S, Johnson N, Alzahrani B, Almahmeed W, Alshehri M, Dahdouh Z, Livingston GS, Chachar TS, Balghith M, Qutub MA, Kahin MA, Abdulhabeeb IAM, Abohasan A, Shawky AM, AlAwadi AN, Alqahtani AH, Alquaid A, Elmahrouk Y, Aloui HM, Hassan T, Elkhereiji A, Rajan R. Clinical characteristics, management, and outcomes of acute myocardial infarction-related cardiogenic shock patients with and without out-of-hospital cardiac arrest: a Gulf region registry analysis. Resusc Plus. 2025 Sep 9;26:101091. doi: 10.1016/j.resplu.2025.101091.
PMID
41050166