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Prognostic significance of non-chest pain symptoms in patients with non-ST-segment elevation myocardial infarction.

Abstract 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.
PMID
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Authors

Mayor MeshTerms
Keywords

Chest pain

Non-ST elevated myocardial infarction

Propensity score

Journal Title the korean journal of internal medicine
Publication Year Start




PMID- 29117666
OWN - NLM
STAT- Publisher
LR  - 20171109
IS  - 2005-6648 (Electronic)
IS  - 1226-3303 (Linking)
DP  - 2017 Nov 10
TI  - Prognostic significance of non-chest pain symptoms in patients with
      non-ST-segment elevation myocardial infarction.
LID - 10.3904/kjim.2017.071 [doi]
AB  - 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.
FAU - Kim, Inna
AU  - Kim I
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Kim, Min Chul
AU  - Kim MC
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Park, Keun Ho
AU  - Park KH
AD  - Department of Cardiology, Chosun University Hospital, Gwangju, Korea.
FAU - Sim, Doo Sun
AU  - Sim DS
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Hong, Young Joon
AU  - Hong YJ
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Kim, Ju Han
AU  - Kim JH
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Jeong, Myung Ho
AU  - Jeong MH
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Cho, Jeong Gwan
AU  - Cho JG
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Park, Jong Chun
AU  - Park JC
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
FAU - Cho, Myeong Chan
AU  - Cho MC
AD  - Department of Cardiology, Chungbuk National University Hospital, Cheongju, Korea.
FAU - Kim, Jong Jin
AU  - Kim JJ
AD  - Department of Cardiology, Kyung Hee University Hospital, Seoul, Korea.
FAU - Kim, Young Jo
AU  - Kim YJ
AD  - Department of Cardiology, Yeungnam University Medical Center, Daegu, Korea.
FAU - Ahn, Youngkeun
AU  - Ahn Y
AD  - Department of Cardiology, Cardiovascular Center, Chonnam National University
      Hospital, Gwangju, Korea.
CN  - Korea Acute Myocardial Infarction Registry Investigators
LA  - eng
PT  - Journal Article
DEP - 20171110
PL  - Korea (South)
TA  - Korean J Intern Med
JT  - The Korean journal of internal medicine
JID - 8712418
OTO - NOTNLM
OT  - Chest pain
OT  - Non-ST elevated myocardial infarction
OT  - Propensity score
EDAT- 2017/11/10 06:00
MHDA- 2017/11/10 06:00
CRDT- 2017/11/10 06:00
PHST- 2017/02/18 00:00 [received]
PHST- 2017/03/27 00:00 [accepted]
PHST- 2017/11/10 06:00 [entrez]
PHST- 2017/11/10 06:00 [pubmed]
PHST- 2017/11/10 06:00 [medline]
AID - kjim.2017.071 [pii]
AID - 10.3904/kjim.2017.071 [doi]
PST - aheadofprint
SO  - Korean J Intern Med. 2017 Nov 10. pii: kjim.2017.071. doi: 10.3904/kjim.2017.071.