News Release

Survivors of heart attack plus cardiac arrest at increased risk of early death

Peer-Reviewed Publication

Imperial College London

Patients who survive a heart attack together with sudden cardiac arrest are at increased risk of dying within six years following hospital discharge.

This is the conclusion of new research published today in the Journal of the American Heart Association.

A heart attack is when blood flow to the heart is blocked, and sudden cardiac arrest is when the heart malfunctions and suddenly stops beating unexpectedly.  Cardiac arrest can be fatal if not treated immediately. 

Most heart attacks do not lead to sudden cardiac arrest. But when sudden cardiac arrest occurs, heart attack is a common cause.

The study, by researchers from the National Institute of Health Research Health Informatics Collaborative (NIHR-HIC) led by Imperial College Healthcare NHS Trust and Imperial College London, draws on data from 13,444 patients collected between 2010 and 2017.  The study was funded by the National Institute for Health Research (NIHR) Imperial Biomedical Research Centre (BRC). 

It shows for the first time that patients who had heart attacks and then a sudden cardiac arrest were at a greater risk of developing further complications. Those who had a cardiac arrest at the time of their heart attack were twice as likely as those suffering heart attack alone to go on to develop abnormal heart rhythms known as ventricular arrhythmia (VA).  Those with a cardiac arrest were also 36 per cent more likely to die on average within three years following discharge from hospital.

The researchers suggest that this small subgroup of patients may benefit from additional treatments such an implantable cardioverter defibrillator (ICD) – a small device that treats people with abnormal heart rhythms – to see if it improves their long-term health outcomes.  This is because in some cases heart attacks can lead to a condition called ventricular arrhythmia (VA) – a type of abnormal heartbeat where the heart begins beating faster before going into a spasm and stops pumping completely- which can cause sudden cardiac arrest. 

Dr Fu Siong Ng, senior author of the study and Clinical Senior Lecturer in Cardiac Electrophysiology at Imperial College London, said:

“Most patients who have heart attacks do not experience a cardiac arrest.  However, our study has revealed that there are a small group of patients who do, and if they survive the initial cardiac arrest they are at increased of further complications and early death. This study has highlighted that we may need to look at how we treat these types of patients and our current guidelines may need to be updated.  There is a case that in addition to the current treatments on offer to heart attack patients these patients may benefit from ICDs.  However, we would need to carry out a clinical trial to validate this theory.”

Arunashis Sau, first author of the study and Clinical Research Fellow at Imperial College London, added:

“This is the first study to have found a link between patients who have heart attacks together with sudden cardiac arrests and early death after surviving the initial event.  Our findings have significant implications for this subgroup of patients and how we treat them. The study raises the question on what more we can do to potentially provide more treatment options so that we can improve these patients’ outcomes.”

Doctors treat heart attack patients by unblocking coronary arteries in the heart as well as other treatments such as beta blocker tablets to slow down the heart.  Patients who experience cardiac arrests are treated with a defibrillator- a device that gives a high energy electric shock to get the heart beating again. 

Previous studies have suggested that patients who experience a sudden cardiac arrest following a heart attack may represent a subgroup of patients who are at risk of further complications such as VA.

However, these studies have limited long-term follow-up data of patients and these studies are significantly smaller.

Researchers wanted to analyse the long-term impact of sudden cardiac arrest on heart attack patients.

They analysed clinical data of 13,444 heart attack patients who were admitted and discharged from five NHS Trust hospitals in England.  They were followed up on average for three years.  A total of 280 patients had a heart attack and cardiac arrest and survived to discharge. 

They found that these patients were over twice as likely to have subsequent VA at follow-up.  They also found that there was a 36 per cent increase in death within three years of discharge, compared with the group of patients who had a heart attack, but not a cardiac arrest.

The researchers suggest that further studies are needed to fully assess how to reduce the risk of recurrent VA in this cohort, and whether an ICD should be considered for patients who present with cardiac arrest and a heart attack.


For more information, please contact:

Maxine Myers
AHSC Communications Manager
Imperial College London 
Tel:  +44 (0) 7561 451724
Duty press officer mobile: +44 (0) 7803 886248

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  1. About Imperial College Academic Health Science Centre (AHSC) 

The AHSC is a partnership between Imperial College London, The Institute of Cancer Research (ICR) Imperial College Healthcare NHS Trust, Chelsea and Westminster NHS Foundation Trust and the Royal Marsden NHS Foundation Trust, based in West London. 

Established in 2007, it was the first AHSC to be created in the UK and was formally designated by the Department of Health in 2009. 

The partnership brings together multi-disciplinary research and education from across all faculties at the College with the resources and critical mass of the three Trusts to advance discovery and innovation within healthcare. 

The purpose of Imperial College AHSC is to utilise excellence in research and education to transform health outcomes, and support the UK's globally competitive position in healthcare related industries by increasing societal and economic gain. 

The AHSC is nested within Imperial College Health Partners, the Academic Health Science Network for North West London, which will ensure that discoveries and innovations are applied on a national and global scale. 

2. About Imperial College London

Imperial College London is one of the world's leading universities. The College's 16,000 students and 8,000 staff are expanding the frontiers of knowledge in science, medicine, engineering and business, and translating their discoveries into benefits for society. 

Founded in 1907, Imperial builds on a distinguished past - having pioneered penicillin, holography and fibre optics - to shape the future. Imperial researchers work across disciplines to improve health and wellbeing, understand the natural world, engineer novel solutions and lead the data revolution. This blend of academic excellence and its real-world application feeds into Imperial's exceptional learning environment, where students participate in research to push the limits of their degrees. 

Imperial collaborates widely to achieve greater impact. It works with the NHS to improve healthcare in west London, is a leading partner in research and education within the European Union, and is the UK's number one research collaborator with China. 

Imperial has nine London campuses, including its White City Campus: a research and innovation centre that is in its initial stages of development in west London. At White City, researchers, businesses and higher education partners will co-locate to create value from ideas on a global scale. 

Imperial College London is a world-class university with a mission to benefit society through excellence in science, engineering, medicine and business.

3.  About Imperial College Healthcare NHS Trust

Imperial College Healthcare NHS Trust is one of the largest hospital Trust's in England, providing acute and specialist healthcare for a population of nearly two million people. The Trust has five hospitals - Charing Cross, Hammersmith, Queen Charlotte's & Chelsea, St Mary's and The Western Eye as well as community services.



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