Despite improvements in the survival rate of acute myocardial infarction (AMI), out-of-hospital cardiac arrest (OHCA) due to AMI is still a devastating condition. Thrombolysis in myocardial infarction (TIMI) grade is used to classify coronary reperfusion after percutaneous coronary intervention (PCI), but it remains unclear whether TIMI grade after emergent PCI is associated with short-term mortality in patients with AMI who have suffered OHCA. We analyzed data collected from 2012 to 2017 and recorded in the Yamagata AMI registry, which is a multicenter surveillance conducted in all institutions in Yamagata prefecture. Among 3332 patients with AMI, 254 had suffered OHCA. There were 564 deaths during the 30 days after the onset of AMI. The survival rate was lower in patients who had suffered OHCA than in those who had not (40% vs. 87%; P < 0.0001). Patients with AMI who had suffered OHCA were divided into three groups based on TIMI grade (TIMI III group, n = 70; TIMI ≤ II group, n = 21; and no coronary angiography [non-CAG] group, n = 163). The survival rates in the TIMI III, TIMI ≤ II, and non-CAG groups were 87%, 38%, and 5%, respectively. Kaplan–Meier analysis demonstrated that the survival rate was highest in the TIMI III group. Multivariate Cox proportional hazard regression analysis demonstrated that TIMI III was closely associated with survival after adjustment for confounding factors. Achieving TIMI grade III during emergent PCI is crucial to improve survival in patients with AMI who have suffered OHCA.

尽管急性心肌梗死 (AMI) 的存活率有所提高，但由 AMI 引起的院外心脏骤停 (OHCA) 仍然是一种毁灭性的疾病。心肌梗死溶栓（TIMI）分级用于对经皮冠状动脉介入治疗（PCI）后的冠状动脉再灌注进行分类，但尚不清楚急诊PCI后的TIMI分级是否与患有OHCA的AMI患者的短期死亡率相关。我们分析了从 2012 年到 2017 年收集并记录在 Yamagata AMI 登记处的数据，该登记处是在山形县所有机构进行的多中心监测。在 3332 名 AMI 患者中，254 名患有 OHCA。AMI 发病后 30 天内有 564 人死亡。患有 OHCA 的患者的生存率低于未患有 OHCA 的患者（40% vs. 87%；P  < 0.0001)。患有 OHCA 的 AMI 患者根据 TIMI 分级分为三组（TIMI III 组，n  = 70；TIMI ≤ II 组，n  = 21；无冠状动脉造影 [non-CAG] 组，n  = 163）。TIMI III、TIMI ≤ II 和非 CAG 组的存活率分别为 87%、38% 和 5%。Kaplan-Meier 分析表明，TIMI III 组的存活率最高。多变量 Cox 比例风险回归分析表明，在调整混杂因素后，TIMI III 与生存率密切相关。在急诊 PCI 期间达到 TIMI III 级对于提高患有 OHCA 的 AMI 患者的生存率至关重要。