Cardiovascular News Briefs

Emergency Medical Service Providers Affect Survival After Cardiac Arrest

A person’s odds of survival after a cardiac arrest can differ by more than 50 percent depending on which emergency medical service (EMS) agency provides initial care, according to a new study published in JAMA Cardiology. The researchers analyzed data from the Resuscitation Outcomes Consortium. They looked at 43,656 patients treated by 112 EMS agencies. The lowest performing agents had zero survivors out of 36 patients, while the best had 66 survivors out of 228 patients treated. A wide variation of survival rates existed even when patients had similar EMS arrival times, the same shockable rhythm status, the same number of epinephrine administrations, and the same rate of bystander cardiopulmonary resuscitation interventions.

Low-Dose Aspirin May Increase the Risk of Hemorrhage

A large study published in the New England Journal of Medicine has cast doubt on the safety of taking preventive low-dose aspirin daily for people over the age of 65. While previous studies have shown that the benefits of reducing the risk of heart attack or stroke outweigh the risks in people in their 50s who have a 10 percent or greater risk of cardiovascular disease, this new study suggests that it may cause a higher risk of hemorrhage in older people. The Aspirin in Reducing Events in the Elderly (ASPREE) trial recruited close to 20,000 healthy people with no evidence of heart disease, dementia, or persistent physical disability. Half of the participants took 100 milligrams of aspirin per day while the other half took a placebo. After five years, there was no difference in disability-free survival, but the incidence of major hemorrhage was higher in the aspirin group than in the placebo group, amounting to an additional 2.4 serious bleeding events per 1,000 person-years of exposure. The authors noted that the trial duration was relatively short and that additional risks or benefits may have emerged if the trial had been longer. The authors did not comment on whether people who are currently taking aspirin for primary prevention should continue or discontinue its use.

Cardiac Arrests No Longer Peak on Weekday Mornings

Weekday mornings, especially Mondays, have historically seen a peak in cardiac arrest deaths, but research shows that the peak has now disappeared. A Cedars-Sinai Medical Center study of 1,535 sudden cardiac arrest deaths between 2004 and 2014 found that only 13.9 percent of patients died between 6 and 10 a.m. Furthermore, there were no more deaths on Mondays (generally considered the highest-risk day) than on any other day. The researchers suggested that rising levels of stress may play a role in the shift.

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