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Study finds lower survival rates of cardiac arrest from Asian adults

Asian adults are less likely to survive out-of-hospital cardiac arrest (OCHA) than their White peers, according to a new study published in the Journal of American Heart of Association on Wednesday.

Researchers reviewed data from the Cardiac Arrest Registry to Enhance Survival (CARES), a registry for out-of-hospital cardiac arrests (OHCA), for nearly 279,000 out-of-hospital cardiac arrests concerning Asian and White adults in the U.S between 2013 and 2021. From the data they analyzed, 5% of out-of-hospital cardiac arrests occurred in Asian adults while 95% occurred in White adults.

Comparing the two patient groups, Asian individuals with OHCA were older on average (67 years) than White individuals (62 years). Asian adults with OCHA were more likely to be women (36% vs. 34%) and less likely to suffer cardiac arrest from a drug overdose (1% vs. 6%). Asian adults were also less likely to have an arrest rhythm that benefited from using an automated external defibrillator (19% vs. 22%).

Researchers found that Asian adults were 8% less likely to survive and 15% less likely to survive without neurological problems, in comparison to White adults.

The study was not able to consider Asian subgroups such as East, Southeast, and South Asian so this study reports on Asians as one group. The findings may not be extended to rural areas in the U.S because of the underrepresentation of information from those regions in the CARES registry. Researchers also found that the CARES registry information on race is 93% accurate for White individuals with OCHA and around 70% accurate for Asian individuals with OCHA.

The study also revealed that Asian individuals are just as likely to receive CPR from a bystander as their White counterparts.

Asian and White adults, who had a cardiac arrest at their private residence or in public, roughly experience a 42% chance of receiving life-saving CPR from someone who witnessed it.

“We were surprised that rates of bystander CPR in Asian adults were the same as white adults, as we have previously found that Black and Hispanic persons with out-of-hospital cardiac arrest have much lower rates of bystander CPR than white persons,” said Dr. Paul Chan, senior author of the study and a professor of medicine at Saint Luke’s Mid America Heart Institute and the University of Missouri-Kansas City, in a news release.

The researchers expected to see lower rates of Asian adults receiving CPR from a bystander than White adults, according to Chan.

Dr. Joseph Wu, volunteer president of the American Heart Association, director of the Stanford Cardiovascular Institute and the Simon H. Stertzer Professor of Medicine and Radiology at Stanford School of Medicine, offered that it was “quite encouraging” that the bystander CPR rates for Asian and White adults were comparable.

Given the discrepancy between the rates of receiving CPR from a bystander and the rates of survival from OCHA for Asian individuals, the findings suggest further investigation into an explanation for the lower survival rates.

“Receiving bystander CPR is usually a very strong predictor of survival after out-of-hospital cardiac arrest, therefore, it is not entirely clear what may be driving the lower survival rate among Asian adults,” Chan said in a news release.

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