THE OUT-OF-HOSPITAL CARDIAC ARREST IN PATIENTS WITH ACUTE MYOCARDIAL INFARCTION AND PRE-EXISTING AORTIC STENOSIS.

Pre-existing significant aortic stenosis(sAS) in patients with out-of-hospital cardiac arrest(OHCA) may lead to ineffective chest compressions due to hemodynamic of stenosis, reducing the probability of return of spontaneous circulation,and the resuscitation may be complicated. We aimed to analyze the influence of sAS on the risk of OHCA in AMI(AMI-OHCA),on the complicity of resuscitation and survival. The analysis was based on national registries of coronary interventions,reimbursed health rervices and deaths. Our dataset included all AMI-OHCA patients(N=4,414) in the country(2017-2021),of whom 1.8%patients had pre-existing sAS(Table 1). The incidence of sAS was 1.7% in OHCA and 1.8% in AMI without OHCA,p=0.66. The AMI-OHCA patients were divided into three groups–those who died during OHCA(N=238, AS in 4.2%), those who were admitted after OHCA on mechanical ventilation(N=3,255, AS in 1.8%) and spontaneously ventilating(N=921, AS in 1.2%). Multivariate analysis showed that sAS was not a risk factor for the use of mechanical ventilation in AMI-OHCA, OR1.61(95%CI 0.83;3.09),p=0.16, however sAS presents a significant risk of pre-hospital mortality of AMI-OHCA, OR3.4(95%CI 1.20;9.58),p=0.02. Additionally, in-hospital, 30-day, and long-term prognosis of AMI-OHCA is adversely affected by sAS, OR2.47(95%CI 1.38;4.41), 2.83(95%CI 1.61;4.95), and 1.81(95%CI 1.38;2.38) vs. non-VHD respectively,p