Characteristics of patients with false- ST-segment elevation myocardial infarction diagnoses
| Autor: | Hilde E. Groot, Chris P. H. Lexis, Wouter G. Wieringa, Karim D. Mahmoud, Erik Lipsic, Pim van der Harst, Bart Hiemstra |
|---|---|
| Přispěvatelé: | Cardiovascular Centre (CVC) |
| Jazyk: | angličtina |
| Rok vydání: | 2016 |
| Předmět: |
Male
Multivariate analysis medicine.medical_treatment PRIMARY PCI 030204 cardiovascular system & hematology Critical Care and Intensive Care Medicine False-positive activation 0302 clinical medicine Risk Factors ST segment 030212 general & internal medicine Myocardial infarction Medical diagnosis Incidence (epidemiology) General Medicine Middle Aged PREVALENCE TIME surgical procedures operative TRIALS Cardiology Female Cardiology and Cardiovascular Medicine Adult medicine.medical_specialty STEMI 03 medical and health sciences Age Distribution Internal medicine Fibrinolysis Heart rate medicine Humans FIBRINOLYSIS cardiovascular diseases Diagnostic Errors Aged business.industry percutaneous coronary intervention nutritional and metabolic diseases Percutaneous coronary intervention medicine.disease nervous system diseases ST-segment elevation myocardial infarction CATHETERIZATION LABORATORY ACTIVATION REGISTRY Multivariate Analysis ST Elevation Myocardial Infarction coronary angiography business MATTER |
| Zdroj: | European Heart Journal: Acute Cardiovascular Care, 5(4), 339-346. SAGE Publications Inc. |
| ISSN: | 2048-8726 |
| Popis: | Background: A subgroup of patients presenting with suspected ST-elevation myocardial infarction (STEMI) have no culprit lesion during coronary angiography (false-positive STEMI). Little is known about patient- and system-related factors that are associated with false-positive STEMI. We evaluated the incidence, correlates, delay, final diagnosis, and outcome of patients with false-positive STEMI.Methods: We studied 827 consecutive patients presenting with suspected STEMI between January 2011-September 2012.Results: A false positive STEMI activation was identified in 68 patients (8.2%). Patients with false-positive STEMI were younger (57 vs 63 year; p=0.020), less often had hypercholesterolemia (19 vs 43%; p=0.001), and had a higher heart rate (82 vs 75 bpm; p=0.014). The association between these factors and false-positive STEMI activation persisted in multivariate analysis. The duration of symptoms to call was longer in false-positive STEMI patients (128 vs 83 min; p=0.030), although this did not reach statistical significance in multivariate analysis. Final diagnosis in patients with false-positive STEMI activation was particularly from unknown origin (41%). There were no significant differences in mortality at 30 days and one year between patients with STEMI and false-positive STEMI.Conclusion: The incidence of false-positive STEMI was 8.2% in patients suspected of STEMI. Patients with false-positive STEMI differ from STEMI patients in certain baseline characteristics and in patient delay. Interestingly, absence of coronary disease did not translate into better clinical outcome. |
| Databáze: | OpenAIRE |
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