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Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction
The Korean Journal of Internal Medicine ; : 1111-1118, 2018.
Artigo em Inglês | WPRIM | ID: wpr-718183
ABSTRACT
BACKGROUND/

AIMS:

Chest pain is an essential symptom in the diagnosis of acute coronary syndrome (ACS). One-third of patients with ACS present atypically, which can influence their receiving timely lifesaving therapy.

METHODS:

A total of 617 NSTEMI patients from the Korea Acute MI Registry (KAMIR) and the Korea Working Group on MI (KorMI) databases were analyzed. The study population was divided into two groups by symptoms at presentation (typical symptoms group, 128; atypical symptoms groups, 128).

RESULTS:

In this study population, 23% of patients presented without chest pain. After propensity score matching, the contact-to-device time (2,618 ± 381 minutes vs. 1,739 ± 241 minutes, p = 0.050), the symptoms-to-balloon time (3,426 ± 389 minutes vs. 2,366 ± 255 minutes, p = 0.024), and the door-to-balloon time (2,339 ± 380 minutes vs. 1,544 ± 244 minutes, p = 0.002) were significantly higher in the patients with atypical symptoms than in those with typical symptoms, respectively. Atypical symptoms were an independent predictor for 1-year mortality (hazard ratio, 2.820; 95% confidence interval, 1.058 to 7.515; p = 0.038). The Kaplan-Meier estimates showed higher risk for 12-month mortality in patients with atypical symptoms (p = 0.048) and no significant difference for 12-month major adverse cardiac events (p = 0.487).

CONCLUSIONS:

Acute myocardial infarction patients with atypical symptoms were not rare in clinical practice and showed a high risk of delayed reperfusion therapy. After imbalance between the groups was minimized by use of propensity score matching, patients who presented atypically had a high mortality rate.
Assuntos

Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Dor no Peito / Reperfusão / Mortalidade / Diagnóstico / Síndrome Coronariana Aguda / Pontuação de Propensão / Coreia (Geográfico) / Infarto do Miocárdio Tipo de estudo: Estudo diagnóstico / Estudo prognóstico Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: The Korean Journal of Internal Medicine Ano de publicação: 2018 Tipo de documento: Artigo

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Texto completo: DisponíveL Índice: WPRIM (Pacífico Ocidental) Assunto principal: Dor no Peito / Reperfusão / Mortalidade / Diagnóstico / Síndrome Coronariana Aguda / Pontuação de Propensão / Coreia (Geográfico) / Infarto do Miocárdio Tipo de estudo: Estudo diagnóstico / Estudo prognóstico Limite: Humanos País/Região como assunto: Ásia Idioma: Inglês Revista: The Korean Journal of Internal Medicine Ano de publicação: 2018 Tipo de documento: Artigo