| Autor: |
Jun-Won Lee, Jin Sil Moon, Dae Ryong Kang, Sang Jun Lee, Jung-Woo Son, Young Jin Youn, Sung Gyun Ahn, Min-Soo Ahn, Jang-Young Kim, Byung-Su Yoo, Seung-Hwan Lee, Ju Han Kim, Myung Ho Jeong, Jong-Seon Park, Shung Chull Chae, Seung Ho Hur, Myeng-Chan Cho, Seung Woon Rha, Kwang Soo Cha, Jei Keon Chae, Dong-Ju Choi, In Whan Seong, Seok Kyu Oh, Jin Yong Hwang, Junghan Yoon |
| Jazyk: |
angličtina |
| Rok vydání: |
2020 |
| Předmět: |
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| Zdroj: |
Journal of Clinical Medicine, Vol 9, Iss 2, p 505 (2020) |
| Druh dokumentu: |
article |
| ISSN: |
2077-0383 |
| DOI: |
10.3390/jcm9020505 |
| Popis: |
Atypical chest pain and diabetic autonomic neuropathy attract less clinical attention, leading to underdiagnosis and delayed treatment. To evaluate the long-term clinical impact of atypical chest pain and diabetes mellitus (DM), we categorized 11,159 patients with acute myocardial infarction (AMI) from the Korea AMI-National Institutes of Health between November 2011 and December 2015 into four groups (atypical DM, atypical non-DM, typical DM, and typical non-DM). The primary endpoint was defined as patient-oriented composite endpoint (POCE) at 2 years including all-cause death, any myocardial infarction (MI), and any revascularization. Patients with atypical chest pain showed higher 2-year mortality than those with typical chest pain in both DM (29.5% vs. 11.4%, p < 0.0001) and non-DM (20.4% vs. 6.3%, p < 0.0001) groups. The atypical DM group had the highest risks of POCE (hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.48−2.10), all-cause death (HR 2.23, 95% CI 1.80−2.76) and any MI (HR 2.34, 95% CI 1.51−3.64) in the adjusted model. In conclusion, atypical chest pain was significantly associated with mortality in patients with AMI. Among four groups, the atypical DM group showed the worst clinical outcomes at 2 years. Application of rapid rule in/out AMI protocols would be beneficial to improve clinical outcomes. |
| Databáze: |
Directory of Open Access Journals |
| Externí odkaz: |
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