Response by DeFilippis et al to Letter Regarding Article, "Long-Term Outcomes After Out-of-Hospital Cardiac Arrest in Young Patients With Myocardial Infarction: Partners YOUNG-MI Registry".

Circulation. 2019;139:e996. DOI: 10.1161/CIRCULATIONAHA.119.040324 e996 Ersilia M. DeFilippis, MD Avinainder Singh, MBBS, MSSc Deepak L. Bhatt, MD, MPH Ron Blankstein, MD In Response: We recently reported the results of the YOUNG-MI registry focusing on outcomes after out-of-hospital cardiac arrest (OHCA) in patients presenting with a first myocardial infarction at ≤50 years of age.1 We found that patients with OHCA were more likely to die in hospital compared with patients without OHCA. However, if patients with OHCA survived to hospital discharge, long-term all-cause mortality and cardiovascular mortality were similar to those in individuals without OHCA. We read with interest the letter by Karam et al. The authors astutely mention that our incidence of OHCA is likely underestimated by virtue of the fact that, by design, we capture only patients who made it to the hospital. OHCA registries such as the Resuscitation Outcomes Consortium and CARES (Cardiac Arrest Registry to Enhance Survival) can also provide valuable information, but certain details on subsequent postarrest management and outcomes may be lacking. Strengths of our YOUNG-MI registry include its ability to provide long-term follow-up and the fact that we focused exclusively on young patients.2 Nevertheless, this highlights the need for better mechanisms to capture myocardial infarction–related OHCA in the community where information can be shared among all emergency and cardiac care providers.3 Despite these limitations, our findings on postarrest management, in-hospital outcomes, and posthospital discharge are still applicable to those patients with OHCA who reach the hospital.