Opioid-related cardiac arrest patients differ from other cardiac arrests

November 11, 2019

DALLAS, Nov. 11, 2019 -- One recent study found that opioid overdose victims who suffer cardiac arrest are distinctly different from other cardiac arrest patients, yet they may be more likely than others to survive long enough to be admitted to a hospital, according to preliminary research to be presented at the American Heart Association's Resuscitation Science Symposium 2019 -- November 16-17 in Philadelphia.

"Cardiac arrests due to opioid overdose are increasingly common and make up a separate population that should be researched and cared for as a separate group in order to improve overall outcomes," said lead study author Teresa May, D.O., an investigator at the Maine Medical Research Center, in Portland.

May and colleagues identified all emergency 9-1-1 responses in Maine for non-traumatic, out-of-hospital cardiac arrests, particularly noting opioid-overdose cases or cases when the overdose rescue medication naloxone was administered. There were 3,131 EMS responses in Maine in 2016-2017 for out-of-hospital cardiac arrests, of which 168 were attributed to opioid overdose. Compared to other cardiac arrest victims, drug overdose-associated cardiac arrest victims were:The investigators also studied whether living in urban or rural locations made any difference and found that opioid-related incidents were three times more likely in metropolitan or large rural areas versus smaller, more remote locations.

After adjusting the findings for age, gender, initial shockable heart rhythm, whether the cardiac arrest was witnessed, if bystander CPR was administered and rural location, the odds of overdose patients surviving to the emergency department were 80% higher than for those suffering a non-opioid-related cardiac arrest.

"Given what we found, it might be appropriate to consider thinking about these cardiac arrest cases differently and to raise awareness among first responders and emergency room providers that opioid-related cardiac arrests are in fact different from other cardiac arrest cases," said May. "I believe patients who suffer a cardiac arrest due to opioid overdose should be recognized and studied as an entirely different type of cardiac patient. They may require different pre-hospital and in-hospital treatment than other patients with cardiac arrest."

In December 2018, the American Heart Association introduced a new online instructional course series titled "Opioid Education for Health Care Providers" and "Opioid Education for Non-Clinical Staff and Lay Responders" to train paramedics, nurses, physicians, other emergency healthcare professionals and bystanders in how to best respond to cardiac emergencies in opioid overdoses.

"Appropriate, science-based emergency care is critical for patients with cardiac arrest. This study indicates that opioid-related cardiac arrest has unique characteristics that should be considered in order to improve patient outcomes," said Eduardo Sanchez, M.D., M.P.H., FAAFP, American Heart Association Chief Medical Officer for Prevention.
-end-
May and colleagues are continuing to study the Maine data in more detail, and they will review and analyze similar data from New Hampshire and Vermont in their next studies.

Co-authors are Matthew Sholl, M.D.; Lee Lucas, R.N., Ph.D.; David Gagnon, Pharm.D.; Patricia Lerwick, M.D.; Richard R. Riker, M.D.; David B. Seder, M.D.; and Bailey West. Author disclosures are in the abstract.

Additional Resources:Statements and conclusions of study authors that are presented at American Heart Association scientific meetings are solely those of the study authors and do not necessarily reflect Association policy or position. The Association makes no representation or warranty as to their accuracy or reliability. The Association receives funding primarily from individuals; foundations and corporations (including pharmaceutical, device manufacturers and other companies) also make donations and fund specific Association programs and events. The Association has strict policies to prevent these relationships from influencing the science content. Revenues from pharmaceutical and device corporations are available at https://www.heart.org/en/about-us/aha-financial-information.

The American Heart Association's Resuscitation Science Symposium (ReSS) is a premier global exchange providing transdisciplinary interactions that rapidly translate advances in the resuscitation field from fundamental to translational to clinical to population science. For the first time, the 2019 Resuscitation Science Symposium will be a two-day international stand-alone conference, Nov. 16-17 at The Philadelphia 201 Hotel in Philadelphia. The audience will include emergency physicians, trauma surgeons, neurosurgeons, cardiologists, critical-care nurses, intensivists, emergency medical providers, resuscitation educators and researchers with basic, bioengineering, clinical or other experience related to treating cardiac arrest and trauma.

About the American Heart Association

The American Heart Association is a relentless force for a world of longer, healthier lives. We are dedicated to ensuring equitable health in all communities. Through collaboration with numerous organizations, and powered by millions of volunteers, we fund innovative research, advocate for the public's health and share lifesaving resources. The Dallas-based organization has been a leading source of health information for nearly a century. Connect with us on heart.org, Facebook, Twitter or by calling 1-800-AHA-USA1.

American Heart Association

Related Cardiac Arrest Articles from Brightsurf:

Outcomes for out-of-hospital cardiac arrest during COVID-19 pandemic
This study used a large US registry of out-of-hospital cardiac arrests to asses the association between the COVID-19 pandemic and the outcomes of out-of-hospital cardiac arrests, including in areas with low and moderate COVID-19 disease.

Cardiac arrest is common in critically ill patients with COVID-19
Cardiac arrest is common in critically ill patients with covid-19 and is associated with poor survival, particularly among patients aged 80 or older, finds a study published by The BMJ today.

In-hospital cardiac arrest in COVID-19
Outcomes of in-hospital cardiac arrest among patients with COVID-19 are examined in this case series.

New risk tool developed for cardiac arrest patients
Experts have developed a risk score to predict cardiac arrest patient outcomes.

Intravenous sodium nitrite ineffective for out-of-hospital cardiac arrest
Among patients who had an out-of-hospital cardiac arrest, intravenous sodium nitrite given by paramedics during resuscitation did not significantly improve their chances of being admitted to or discharged from the hospital alive, according to research presented at the American College of Cardiology's Annual Scientific Session Together with World Congress of Cardiology (ACC.20/WCC).

Getting to the heart of epinephrine use in pediatric cardiac arrest patients
The effectiveness of epinephrine treatment during resuscitation of adult patients with cardiac arrest is generally promising, but little is known about its effects in pediatric patients.

Bystanders can help more cardiac arrest victims survive
Only 8% of Americans survive cardiac arrest outside a hospital, but that percentage could increase significantly if bystanders recognize cardiac arrest and perform simple lifesaving tasks, a UVA Health physician says in a New England Journal of Medicine article.

Opioid-related cardiac arrest patients differ from other cardiac arrests
People who suffer cardiac arrest due to an opioid overdose are younger, have fewer chronic medical conditions and may be more likely to be to receive bystander CPR, according to a review of emergency response records in Maine.

Selective coronary angiography following cardiac arrest
In the current issue of Cardiovascular Innovations and Applications volume 4, issue 2, pp.

Sudden cardiac arrest in athletes: Prevention and management
It's marathon season, and every so often a news report will focus on an athlete who has collapsed from sudden cardiac arrest.

Read More: Cardiac Arrest News and Cardiac Arrest Current Events
Brightsurf.com is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to Amazon.com.