(PE) is a relatively common cardiovascular condition, occasionally
and tragically manifesting as Sudden Cardiac Arrest (SCA). The
natural history of SCA complicating PE has been poorly evaluated.In
this study, we described the management and outcome of PE-related
In this prospective
population-based study, we included all patients admitted at
hospital alive after out of hospital SCA, in Paris and
suburbs, France (6.6 million inhabits), from May 2011 to September
Of 2926 patients
hospitalized after SCA, 82 cases were diagnosed as PE-related SCA
(2.8%, 95%CI = 2.2–3.4). Systemic thrombolysis was performed in
47 patients (57%), without significant increased risk of major
bleeding among patients treated with thrombolysis. 12 patients (15%)
were treated with ECLS, 29 patients (36%) had targeted temperature
management, and 20 patients (24%) underwent coronary angiography. 94%
of PE-related SCA had initial non-shockable rhythm, and were
associated with better survival compared with other non-shockable SCA
(crude OR = 3.0, 95%CI = 1.7–5.4, P less than 0.001;
adjusted OR = 4.1, 95%CI 2.0–8.3, P less than 0.001).
Among PE-related SCA, thrombolysis was independently associated with
survival (OR = 12.5, 95%CI = 1.8–89.1, P = 0.01).
Multiple sensitivity analysis was performed, with consistent results.
PE is responsible of
approximately 3% of hospitalizations for SCA. Thrombolysis was
associated with an increased survival in this population, reinforcing
current guidelines advocating for such treatment in PE-related SCA.
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