ASSOCIATION BETWEEN SYMPTOM DURATION AND CLINICAL OUTCOMES IN PATIENTS WITH NON-ST ELEVATION MYOCARDIAL INFARCTION
Journal of the American College of Cardiology
; 79(9):1088, 2022.
Article
in English
| EMBASE | ID: covidwho-1768626
ABSTRACT
Background Although the number of patients presenting with non-ST elevation myocardial infarction (NSTEMI) has drastically reduced in the coronavirus-19 pandemic era, increased mortality was reported. A plausible explanation for increased mortality was suggested as the delay of arrival at the hospital due to patients’ reticence of their symptoms. However, evidence to support the suggested explanation is lacking. Methods From the nationwide prospective registry, we evaluated 6,544 patients with NSTEMI. Study patients were categorized into two groups according to their symptom-to-door (StD) time (<24 h or ≥24 h). The primary outcome was 3-year all-cause mortality, and the secondary outcome was 3-year composite of all-cause mortality, recurrent MI, and hospitalization for heart failure. Results Overall, 27.9% patients were classified into the StD time ≥24 h group. The StD time ≥24 h group had higher all-cause mortality (17.0% vs. 10.5%, p<0.001) and incidence of secondary outcome (23.3% vs. 15.7%, p<0.001) than the StD time <24 h group. In the multivariable analysis, independent predictors of delayed arrival at the hospital were the elderly, female, non-specific symptoms such as atypical chest pain or dyspnea, diabetes, and no use of emergency medical services. Conclusion Delayed arrival (StD time ≥24 h) is associated with an increased risk of 3-year all-cause mortality and composite outcomes in patients with NSTEMI. [Formula presented]
aged; all cause mortality; clinical evaluation; clinical outcome; conference abstract; controlled study; Coronavirinae; diabetes mellitus; dyspnea; emergency health service; female; heart failure; hospitalization; human; incidence; major clinical study; mortality; multicenter study; non ST segment elevation myocardial infarction; nonhuman; outcome assessment; pandemic; prospective study; thorax pain
Full text:
Available
Collection:
Databases of international organizations
Database:
EMBASE
Type of study:
Prognostic study
Language:
English
Journal:
Journal of the American College of Cardiology
Year:
2022
Document Type:
Article
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