HHS Public Access Author manuscript Author Manuscript
Ann Intern Med. Author manuscript; available in PMC 2017 October 02. Published in final edited form as: Ann Intern Med. 2016 January 05; 164(1): 23–29. doi:10.7326/M14-2342.
Warning Symptoms Are Associated With Survival From Sudden Cardiac Arrest Eloi Marijon, MD, PhD1,2,3,4,*, Audrey Uy-Evanado, MD1,*, Florence Dumas, MD, PhD2,4, Nicole Karam, MD, MPH2,3,4, Kyndaron Reinier, MPH, PhD1, Carmen Teodorescu, MD, PhD1, Kumar Narayanan, MD1, Karen Gunson, MD5, Jonathan Jui, MD6, Xavier Jouven, MD, PhD2,3,4, and Sumeet S Chugh, MD1
Author Manuscript
1The
Heart Institute, Cedars-Sinai Medical Center, Los Angeles CA, USA
2Paris
Descartes University, Paris, France
3European
Georges Pompidou Hospital, Cardiology Department, Paris, France
4Cardiovascular
Epidemiology Unit, Paris Cardiovascular Research Center (Inserm U970), European Georges Pompidou Hospital, Paris, France 5Department
of Pathology, Oregon Health and Science University, Portland OR, USA
6Department
of Emergency Medicine, Oregon Health and Science University, Portland OR, USA
Abstract Author Manuscript
Background—Survival after sudden cardiac arrest (SCA) remains low and tools for improved prediction of individuals at long-term risk for SCA are still awaited. Alternative short-term approaches aimed at pre-emptive risk stratification and prevention are needed. Objective—To assess characteristics of symptoms in the four weeks prior to SCA, and whether the response to these symptoms may be associated with a better outcome. Design—Ongoing prospective population-based study.
Author Manuscript
Address correspondence to: Sumeet S. Chugh MD, Cedars-Sinai Medical Center, Heart Institute, Advanced Health Sciences Pavilion, Suite A3100, 127 S. Vicente Blvd., Los Angeles, CA 90048, Fax 310-423-3522; Phone 310-423-1206, [email protected]. *These authors contributed equally to this work Full current mailing addresses for all authors Eloi Marijon, Florence Dumas, Nicole Karam, Xavier Jouven; European Georges Pompidou Hospital, Cardiology Department, 20-40 rue Leblanc, 75908 Paris Cedex 15, +33 1 5609 3692 (Tel), +33 6 6283 3848 (Mob), +33 1 5609 2664 (Fax), [email protected], [email protected], [email protected], [email protected] Audrey Uy-Evanado, Carmen Teodorescu, Kyndaron Reinier, Kumar Narayanan, Sumeet Chugh; Cedars-Sinai Medical Center, Heart Institute, Advanced Health Sciences Pavilion, Suite A3100, 127 S. Vicente Blvd., Los Angeles, CA 90048, [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Jonathan Jui, Oregon Health and Science University, Department of Emergency Medicine, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, [email protected] Karen Gunson, Oregon Health and Science University, Department of Pathology, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, [email protected] No Conflict of Interest Reproducible Research Statement Study protocol: Available from Dr. Sumeet S. Chugh (e-mail, [email protected]). Statistical code: Not available. Data set: Not available.
Marijon et al.
Page 2
Setting—Population of approximately one million in the Northwestern US (2002–2012).
Author Manuscript
Patients—Middle-aged residents (35–65 years) suffering from SCA. Measurement—Multiple sources assessment of symptoms in the four weeks preceding SCA and association with survival to hospital discharge.
Author Manuscript
Results—Of 839 SCA patients with comprehensive assessment of symptoms (51±12 years, 75% male), 430 patients (51%; 50% male vs. 53% female, P=0.59) experienced warning symptoms, mainly chest pain and dyspnea. In the majority of symptomatic patients (93%), symptoms recurred during the 24 hours preceding SCA. Only 81 patients (19%) called emergency medical services (911) to report symptoms prior to SCA; these were more likely to be patients with a history of heart disease (P
Ann Intern Med. Author manuscript; available in PMC 2017 October 02. Published in final edited form as: Ann Intern Med. 2016 January 05; 164(1): 23–29. doi:10.7326/M14-2342.
Warning Symptoms Are Associated With Survival From Sudden Cardiac Arrest Eloi Marijon, MD, PhD1,2,3,4,*, Audrey Uy-Evanado, MD1,*, Florence Dumas, MD, PhD2,4, Nicole Karam, MD, MPH2,3,4, Kyndaron Reinier, MPH, PhD1, Carmen Teodorescu, MD, PhD1, Kumar Narayanan, MD1, Karen Gunson, MD5, Jonathan Jui, MD6, Xavier Jouven, MD, PhD2,3,4, and Sumeet S Chugh, MD1
Author Manuscript
1The
Heart Institute, Cedars-Sinai Medical Center, Los Angeles CA, USA
2Paris
Descartes University, Paris, France
3European
Georges Pompidou Hospital, Cardiology Department, Paris, France
4Cardiovascular
Epidemiology Unit, Paris Cardiovascular Research Center (Inserm U970), European Georges Pompidou Hospital, Paris, France 5Department
of Pathology, Oregon Health and Science University, Portland OR, USA
6Department
of Emergency Medicine, Oregon Health and Science University, Portland OR, USA
Abstract Author Manuscript
Background—Survival after sudden cardiac arrest (SCA) remains low and tools for improved prediction of individuals at long-term risk for SCA are still awaited. Alternative short-term approaches aimed at pre-emptive risk stratification and prevention are needed. Objective—To assess characteristics of symptoms in the four weeks prior to SCA, and whether the response to these symptoms may be associated with a better outcome. Design—Ongoing prospective population-based study.
Author Manuscript
Address correspondence to: Sumeet S. Chugh MD, Cedars-Sinai Medical Center, Heart Institute, Advanced Health Sciences Pavilion, Suite A3100, 127 S. Vicente Blvd., Los Angeles, CA 90048, Fax 310-423-3522; Phone 310-423-1206, [email protected]. *These authors contributed equally to this work Full current mailing addresses for all authors Eloi Marijon, Florence Dumas, Nicole Karam, Xavier Jouven; European Georges Pompidou Hospital, Cardiology Department, 20-40 rue Leblanc, 75908 Paris Cedex 15, +33 1 5609 3692 (Tel), +33 6 6283 3848 (Mob), +33 1 5609 2664 (Fax), [email protected], [email protected], [email protected], [email protected] Audrey Uy-Evanado, Carmen Teodorescu, Kyndaron Reinier, Kumar Narayanan, Sumeet Chugh; Cedars-Sinai Medical Center, Heart Institute, Advanced Health Sciences Pavilion, Suite A3100, 127 S. Vicente Blvd., Los Angeles, CA 90048, [email protected]; [email protected]; [email protected]; [email protected]; [email protected] Jonathan Jui, Oregon Health and Science University, Department of Emergency Medicine, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, [email protected] Karen Gunson, Oregon Health and Science University, Department of Pathology, 3181 SW Sam Jackson Park Rd, Portland, OR 97239, [email protected] No Conflict of Interest Reproducible Research Statement Study protocol: Available from Dr. Sumeet S. Chugh (e-mail, [email protected]). Statistical code: Not available. Data set: Not available.
Marijon et al.
Page 2
Setting—Population of approximately one million in the Northwestern US (2002–2012).
Author Manuscript
Patients—Middle-aged residents (35–65 years) suffering from SCA. Measurement—Multiple sources assessment of symptoms in the four weeks preceding SCA and association with survival to hospital discharge.
Author Manuscript
Results—Of 839 SCA patients with comprehensive assessment of symptoms (51±12 years, 75% male), 430 patients (51%; 50% male vs. 53% female, P=0.59) experienced warning symptoms, mainly chest pain and dyspnea. In the majority of symptomatic patients (93%), symptoms recurred during the 24 hours preceding SCA. Only 81 patients (19%) called emergency medical services (911) to report symptoms prior to SCA; these were more likely to be patients with a history of heart disease (P
