Symptoms Predictive of Acute Myocardial Infarction in the Troponin Era: Analysis From the TRAPID-AMI Study
| Autor: | McCord, James, Aurora, Lindsey, Lindahl, Bertil, Giannitsis, Evangelos, Calle-Muller, Carlos, Nowak, Richard, Body, Richard, Christ, Michael, deFilippi, Christopher R, Christenson, Robert H, Jacobsen, Gordon, Alquezar, Aitor, Panteghini, Mauro, Melki, Dina, Plebani, Mario, Verschuren, Franck, French, John, Bendig, Garnet, Weiser, Silvia, Mueller, Christian, TRAPID-AMI Investigators |
|---|---|
| Přispěvatelé: | UCL - SSS/IREC/MEDA - Pôle de médecine aiguë, UCL - (SLuc) Service des urgences |
| Rok vydání: | 2019 |
| Předmět: |
Male
medicine.medical_specialty Time Factors Myocardial Infarction 030204 cardiovascular system & hematology Chest pain Diagnosis Differential Electrocardiography 03 medical and health sciences 0302 clinical medicine Predictive Value of Tests Internal medicine Multicenter trial myocardial infarction symptoms troponin Humans Medicine cardiovascular diseases Myocardial infarction health care economics and organizations Aged Retrospective Studies biology business.industry Reproducibility of Results Electrocardiography in myocardial infarction Odds ratio Middle Aged medicine.disease Troponin Predictive value of tests Cardiology biology.protein Female Myocardial infarction diagnosis medicine.symptom Emergency Service Hospital Cardiology and Cardiovascular Medicine business Biomarkers Follow-Up Studies |
| Zdroj: | Critical pathways in cardiology, Vol. 18, no.1, p. 10-15 (2019) |
| ISSN: | 1535-282X |
| Popis: | The TRAPID-AMI (High Sensitivity Cardiac Troponin T assay for rapid Rule-out of Acute Myocardial Infarction) study evaluated a rapid "rule-out" acute myocardial infarction (AMI). We evaluated what symptoms were associated with AMI as part of a substudy of TRAPID-AMI. There were 1282 patients evaluated from 12 centers in Europe, the United States of America, and Australia from 2011 to 2013. Multiple symptom variables were prospectively obtained and evaluated for association with the final diagnosis of AMI. Multivariate logistic regression analysis was done, and odds ratios (OR) were calculated. There were 213/1282 (17%) AMIs. Four independent predictors for the diagnosis of AMI were identified: radiation to right arm or shoulder [OR = 3.0; confidence interval (CI): 1.8-5.0], chest pressure (OR = 2.5; CI: 1.3-4.6), worsened by physical activity (OR = 1.7; CI: 1.2-2.5), and radiation to left arm or shoulder (OR = 1.7; CI: 1.1-2.4). In the entire group, 131 (10%) had radiation to right arm or shoulder, 897 (70%) had chest pressure, 385 (30%) worsened with physical activity, and 448 (35%) had radiation to left arm or shoulder. Duration of symptoms was not predictive of AMI. There were no symptoms predictive of non-AMI. Relationship between AMI size and symptoms was also studied. For 213 AMI patients, cardiac troponins I values were divided into 4 quartiles. Symptoms including pulling chest pain, supramammillary right location, and right arm/shoulder radiation were significantly more likely to occur in patients with larger AMIs. In a large multicenter trial, only 4 symptoms were associated with the diagnosis of AMI, and no symptoms that were associated with a non-AMI diagnosis. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|