Clinical characteristics and survival in patients with heart failure experiencing in hospital cardiac arrest

In patients with heart failure (HF) who suffered in-hospital cardiac arrest (IHCA), little is known about the characteristics, survival and neurological outcome. We used the Swedish Registry of Cardiopulmonary Resuscitation to study this, including patients aged ≥ 18 years suffering IHCA (2008–2019), categorised as HF alone, HF with acute myocardial infarction (AMI), AMI alone, or other. Odds ratios (OR) for 30-day survival, trends in 30-day survival, and the implication of HF phenotype was studied. 6378 patients had HF alone, 2111 had HF with AMI, 4210 had AMI alone. Crude 5-year survival was 9.6% for HF alone, 12.9% for HF with AMI and 34.6% for AMI alone. The 5-year survival was 7.9% for patients with HF and left ventricular ejection fraction (LVEF) ≥ 50%, 15.4% for LVEF < 40% and 12.3% for LVEF 40–49%. Compared with AMI alone, adjusted OR (95% CI) for 30-day survival was 0.66 (0.60–0.74) for HF alone, and 0.49 (0.43–0.57) for HF with AMI. OR for 30-day survival in 2017–2019 compared with 2008–2010 were 1.55 (1.24–1.93) for AMI alone, 1.37 (1.00–1.87) for HF with AMI and 1.30 (1.07–1.58) for HF alone. Survivors with HF had good neurological outcome in 92% of cases.