Does Antiarrhythmic Drug during Cardiopulmonary Resuscitation Improve the One-month Survival: The SOS-KANTO 2012 Study

SOS-KANTO 2012 study group

Research output: Contribution to journalArticle

3 Citations (Scopus)

Abstract

Background: Antiarrhythmic drugs (AAD) are often used for fatal ventricular arrhythmias during cardiopulmonary resuscitation (CPR). However, the efficacy of initial AAD administration during CPR in improving long-term prognosis remains unknown. This study retrospectively evaluated the effect of AAD administration during CPR on 1-month prognosis in the SOS-KANTO 2012 study population. Methods and Results: Of the 16,164 out-of-hospital cardiac arrest cases, 1350 shock-refractory patients were included: 747 patients not administered AAD and 603 patients administered AAD. Statistical adjustment for potential selection bias was performed using propensity score matching, yielding 1162 patients of whom 792 patients were matched (396 pairs). The primary outcome was 1-month survival. The secondary outcome was the proportion of patients with favorable neurological outcome at 1 month. Logistic regression with propensity scoring demonstrated an odds ratio (OR) for 1-month survival in the AAD group of 1.92 (P < 0.01), whereas the OR for favorable neurological outcome at 1 month was 1.44 (P 0.26). Conclusions: Significantly greater 1-month survival was observed in the AAD group compared with the non-AAD group. However, the effect of ADD on the likelihood of a favorable neurological outcome remains unclear. The findings of the present study may indicate a requirement for future randomized controlled trials evaluating the effect of ADD administration during CPR on long-term prognosis.

Original languageEnglish
Pages (from-to)58-66
Number of pages9
JournalJournal of Cardiovascular Pharmacology
Volume68
Issue number1
DOIs
Publication statusPublished - 2016 Jul 1

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Anti-Arrhythmia Agents
Cardiopulmonary Resuscitation
Survival
Odds Ratio
Out-of-Hospital Cardiac Arrest
Propensity Score
Selection Bias
Cardiac Arrhythmias
Shock
Randomized Controlled Trials
Logistic Models
Pharmaceutical Preparations
Population

Keywords

  • antiarrhythmic drugs
  • favorable neurological outcome
  • refractory ventricular tachycardia/fibrillation

ASJC Scopus subject areas

  • Pharmacology
  • Cardiology and Cardiovascular Medicine

Cite this

Does Antiarrhythmic Drug during Cardiopulmonary Resuscitation Improve the One-month Survival : The SOS-KANTO 2012 Study. / SOS-KANTO 2012 study group.

In: Journal of Cardiovascular Pharmacology, Vol. 68, No. 1, 01.07.2016, p. 58-66.

Research output: Contribution to journalArticle

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title = "Does Antiarrhythmic Drug during Cardiopulmonary Resuscitation Improve the One-month Survival: The SOS-KANTO 2012 Study",
abstract = "Background: Antiarrhythmic drugs (AAD) are often used for fatal ventricular arrhythmias during cardiopulmonary resuscitation (CPR). However, the efficacy of initial AAD administration during CPR in improving long-term prognosis remains unknown. This study retrospectively evaluated the effect of AAD administration during CPR on 1-month prognosis in the SOS-KANTO 2012 study population. Methods and Results: Of the 16,164 out-of-hospital cardiac arrest cases, 1350 shock-refractory patients were included: 747 patients not administered AAD and 603 patients administered AAD. Statistical adjustment for potential selection bias was performed using propensity score matching, yielding 1162 patients of whom 792 patients were matched (396 pairs). The primary outcome was 1-month survival. The secondary outcome was the proportion of patients with favorable neurological outcome at 1 month. Logistic regression with propensity scoring demonstrated an odds ratio (OR) for 1-month survival in the AAD group of 1.92 (P < 0.01), whereas the OR for favorable neurological outcome at 1 month was 1.44 (P 0.26). Conclusions: Significantly greater 1-month survival was observed in the AAD group compared with the non-AAD group. However, the effect of ADD on the likelihood of a favorable neurological outcome remains unclear. The findings of the present study may indicate a requirement for future randomized controlled trials evaluating the effect of ADD administration during CPR on long-term prognosis.",
keywords = "antiarrhythmic drugs, favorable neurological outcome, refractory ventricular tachycardia/fibrillation",
author = "{SOS-KANTO 2012 study group} and Mari Amino and Sadaki Inokuchi and Koichiro Yoshioka and Yoshihide Nakagawa and Yuji Ikari and Hiraku Funakoshi and Katsura Hayakawa and Masakazu Matsuzaki and Atsushi Sakurai and Yoshio Tahara and Naohiro Yonemoto and Ken Nagao and Arino Yaguchi and Naoto Morimura and Shinjiro Wakai and Hiroyuki Otsuka and Seiji Morita and Tomoko Seki and Yousuke Honma and N. Morimura and A. Sakurai and Y. Tahara and A. Yaguchi and K. Nagao and Tagami Takashi and Dai Miyazaki and Tomoko Ogasawara and Kei Hayashida and Masaru Suzuki and M. Amino and Nobuya Kitamura and Tomohisa Nomura and Naoki Shimizu and Akiko Akashi and N. Yonemoto and S. Inokuchi and Yoshihiro Masui and Kunihisa Miura and Haruhiko Tsutsumi and Kiyotsugu Takuma and Ishihara Atsushi and Minoru Nakano and Hiroshi Tanaka and Keiichi Ikegami and Takao Arai and A. Yaguchi and Shigeto Oda and Kenji Kobayashi and Takayuki Suda and Kazuyuki Ono",
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AU - Amino, Mari

AU - Inokuchi, Sadaki

AU - Yoshioka, Koichiro

AU - Nakagawa, Yoshihide

AU - Ikari, Yuji

AU - Funakoshi, Hiraku

AU - Hayakawa, Katsura

AU - Matsuzaki, Masakazu

AU - Sakurai, Atsushi

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AU - Yonemoto, Naohiro

AU - Nagao, Ken

AU - Yaguchi, Arino

AU - Morimura, Naoto

AU - Wakai, Shinjiro

AU - Otsuka, Hiroyuki

AU - Morita, Seiji

AU - Seki, Tomoko

AU - Honma, Yousuke

AU - Morimura, N.

AU - Sakurai, A.

AU - Tahara, Y.

AU - Yaguchi, A.

AU - Nagao, K.

AU - Takashi, Tagami

AU - Miyazaki, Dai

AU - Ogasawara, Tomoko

AU - Hayashida, Kei

AU - Suzuki, Masaru

AU - Amino, M.

AU - Kitamura, Nobuya

AU - Nomura, Tomohisa

AU - Shimizu, Naoki

AU - Akashi, Akiko

AU - Yonemoto, N.

AU - Inokuchi, S.

AU - Masui, Yoshihiro

AU - Miura, Kunihisa

AU - Tsutsumi, Haruhiko

AU - Takuma, Kiyotsugu

AU - Atsushi, Ishihara

AU - Nakano, Minoru

AU - Tanaka, Hiroshi

AU - Ikegami, Keiichi

AU - Arai, Takao

AU - Yaguchi, A.

AU - Oda, Shigeto

AU - Kobayashi, Kenji

AU - Suda, Takayuki

AU - Ono, Kazuyuki

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N2 - Background: Antiarrhythmic drugs (AAD) are often used for fatal ventricular arrhythmias during cardiopulmonary resuscitation (CPR). However, the efficacy of initial AAD administration during CPR in improving long-term prognosis remains unknown. This study retrospectively evaluated the effect of AAD administration during CPR on 1-month prognosis in the SOS-KANTO 2012 study population. Methods and Results: Of the 16,164 out-of-hospital cardiac arrest cases, 1350 shock-refractory patients were included: 747 patients not administered AAD and 603 patients administered AAD. Statistical adjustment for potential selection bias was performed using propensity score matching, yielding 1162 patients of whom 792 patients were matched (396 pairs). The primary outcome was 1-month survival. The secondary outcome was the proportion of patients with favorable neurological outcome at 1 month. Logistic regression with propensity scoring demonstrated an odds ratio (OR) for 1-month survival in the AAD group of 1.92 (P < 0.01), whereas the OR for favorable neurological outcome at 1 month was 1.44 (P 0.26). Conclusions: Significantly greater 1-month survival was observed in the AAD group compared with the non-AAD group. However, the effect of ADD on the likelihood of a favorable neurological outcome remains unclear. The findings of the present study may indicate a requirement for future randomized controlled trials evaluating the effect of ADD administration during CPR on long-term prognosis.

AB - Background: Antiarrhythmic drugs (AAD) are often used for fatal ventricular arrhythmias during cardiopulmonary resuscitation (CPR). However, the efficacy of initial AAD administration during CPR in improving long-term prognosis remains unknown. This study retrospectively evaluated the effect of AAD administration during CPR on 1-month prognosis in the SOS-KANTO 2012 study population. Methods and Results: Of the 16,164 out-of-hospital cardiac arrest cases, 1350 shock-refractory patients were included: 747 patients not administered AAD and 603 patients administered AAD. Statistical adjustment for potential selection bias was performed using propensity score matching, yielding 1162 patients of whom 792 patients were matched (396 pairs). The primary outcome was 1-month survival. The secondary outcome was the proportion of patients with favorable neurological outcome at 1 month. Logistic regression with propensity scoring demonstrated an odds ratio (OR) for 1-month survival in the AAD group of 1.92 (P < 0.01), whereas the OR for favorable neurological outcome at 1 month was 1.44 (P 0.26). Conclusions: Significantly greater 1-month survival was observed in the AAD group compared with the non-AAD group. However, the effect of ADD on the likelihood of a favorable neurological outcome remains unclear. The findings of the present study may indicate a requirement for future randomized controlled trials evaluating the effect of ADD administration during CPR on long-term prognosis.

KW - antiarrhythmic drugs

KW - favorable neurological outcome

KW - refractory ventricular tachycardia/fibrillation

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