Impact of Non-Chest Pain Complaint as a Presenting Symptom on Door-To-Balloon Time and Clinical Outcomes in Patients With Acute ST-Elevation Myocardial Infarction

Title
Impact of Non-Chest Pain Complaint as a Presenting Symptom on Door-To-Balloon Time and Clinical Outcomes in Patients With Acute ST-Elevation Myocardial Infarction
Author(s)
김영조차광수[차광수]박진섭[박진섭]신동훈[신동훈]이대성[이대성]이혜원[이혜원]오준혁[오준혁]최정현[최정현]이한철[이한철]홍택종[홍택종]
Keywords
PERCUTANEOUS CORONARY INTERVENTION; PROPENSITY SCORE METHODS; PRIMARY ANGIOPLASTY; GENDER-DIFFERENCES; MORTALITY; ASSOCIATION; REPERFUSION; DELAY
Issue Date
201412
Publisher
EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
Citation
AMERICAN JOURNAL OF CARDIOLOGY, v.114, no.12, pp.1801 - 1809
Abstract
Many patients with ST-elevation myocardial infarctions (STEMIs) have non-chest pain complaints and are given low priority during triage. This prospective, multicenter, observational, registry-based study investigated the impact of non chest pain complaints on door-to-balloon (DTB) time and clinical outcomes. Patients with STEMI who had undergone primary percutaneous coronary intervention were compared with respect to the presence of chest pain or non-chest pain complaints as presenting symptoms. To eliminate biased estimates, a propensity score model was built, and 2 cohorts of 1:1 matched patients were obtained. Propensity matching identified 2 cohorts of 976 patients each. After comparing patients with chest pain and those with non-chest pain complaints, significant delays in the median DTB time were noted (74 vs 84 minutes, respectively; p <0.001). Non-chest pain complaints were independent predictors of DTB time in the multivariate linear regression models. In-hospital mortality (adjusted hazard ratio HR] 1.402, 95% confidence interval [CI] 0.727 to 2.705, p = 0.313), all-cause mortality (adjusted HR 1.175, 95% CI 0.453 to 3.853, p = 0.642), and major adverse cardiac events at follow, up (adjusted HR 0.139, 95% CI 0.876 to 1.48, p = 0.331) did not differ between the 2 groups of patients. In conclusion, short- and long-term clinical outcomes in patients with STEMI with non-chest pain complaints do not differ from those of patients with chest pain as the presenting symptom, despite having delayed diagnosis and reperfusion. (C) 2014 Elsevier Inc.
URI
http://hdl.handle.net/YU.REPOSITORY/30368http://dx.doi.org/10.1016/j.amjcard.2014.09.017
ISSN
0002-9149
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의과대학 > 내과학교실 > Articles
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