ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Heart Failure and Transplantation
Volume 12 - 2025 | doi: 10.3389/fcvm.2025.1599318
This article is part of the Research TopicFrom Collapse to Recovery: Advances in the Care of Cardiac Arrest and Cardiogenic ShockView all articles
Pre–Arrest Oral Anticoagulants' Impact on Cardiac Arrest Mortality: MIMIC–IV Cohort Retrospect
Provisionally accepted
- Dazhou Central Hospital, DaZhou, China
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Background: The impact of oral anticoagulant use prior to cardiac arrest (CA) on short-term and long-term all-cause mortality remains largely unknown. This study aimed to explore the association between pre-arrest oral anticoagulant use and both immediate and extended survival outcomes following CA. Methods: We identified 1203 adult CA patients from the Medical Information Mart for Intensive Care IV (MIMIC-IV V3.1) database, grouped by prior oral anticoagulant use. Propensity score matching (PSM) was conducted to minimize confounding effects. Adjusted Cox proportional hazards models were applied to account for pre-hospital and hospitalization factors. Results: Patients in the anticoagulant group demonstrated a significantly higher 28-day survival rate (hazard ratio [HR] 0.28; 95% confidence interval [CI] 0.22-0.37; P<0.001). After PSM, 120 patients were assigned to the anticoagulant group and 130 to the non-anticoagulant group. In the matched cohort, patients in the anticoagulant group continued to demonstrate improved 28-day survival compared to the non-anticoagulant group (HR 0.40; 95% CI 0.27-0.60; P<0.001). Consistent survival benefits were observed at 90, 180, and 365 days. Subgroup analyses further supported these findings. Conclusion: Pre-arrest oral anticoagulant use may be associated with improved survival outcomes in CA patients.
Keywords: Cardiac arrest, Oral anticoagulants, MIMIC database, Propensity score matching, Mortality
Received: 24 Mar 2025; Accepted: 20 Oct 2025.
Copyright: © 2025 Nie, He and Zheng. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Xiangde Zheng, xiangdezhengs017@163.com
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