Key result
First presentation acute myocardial infarction was associated with an odds ratio of 1.16 (95% CI 0.74-1.83) for overall mortality compared to patients with a history of acute coronary syndrome.
Why the study?
Do clinical characteristics and outcomes differ between patients with first presentation AMI compared to those with a history of ACS?
Observational (n=7,930)
Yes
Do clinical characteristics and outcomes differ between patients with first presentation AMI compared to those with a history of ACS?
Odds Ratio: 1.16 (95% CI 0.74–1.83)
Patients with first presentation AMI tend to be older with fewer traditional risk factors but experience higher rates of adverse clinical outcomes compared to those with a history of ACS.
Comparable mortality after first-presentation AMI; leaves open whether baseline differences drive other outcomes in observational cohorts.
BACKGROUND AND OBJECTIVES: Limited data are available highlighting the different clinical aspects of acute coronary syndrome (ACS) patients, especially in Gulf countries. In this study, we aimed to compare patients who presented with acute myocardial infarction (AMI) as the first presentation of patients who have a history of ACS in terms of initial presentation, medical history, laboratory findings, and overall mortality. METHODS: We used the Second Gulf Registry of Acute Coronary Events (Gulf RACE-II), which is a multinational observational study of 7930 ACS patients. RESULTS: < 0.001) and had lower risk factors than patients with a history of ACS. Higher laboratory readings of cardiac markers and all aspects of mortality were significantly higher among patients with first presentation AMI. After adjustments for baseline variables, congestive heart failure [odds ratio (OR) = 1.08; 95% confidence interval (CI), 0.73-1.57], reinfarction (OR = 1.16; 95% CI, 0.58-2.30), cardiogenic shock (OR = 1.51; 95% CI, 0.74-3.08), stroke (OR = 2.30; 95% CI, 0.29-17.99), and overall mortality (OR = 1.16; 95% CI = 0.74-1.83) were independent predictive factors for first presentation AMI. CONCLUSIONS: First presentation AMI patients tend to be older and to have lower rates of risk factors. Adverse clinical outcomes such as congestive heart failure, reinfarction, cardiogenic shock, and stroke were higher among patients with first presentation AMI compared to patients with a history of ACS.
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Joury et al. (2018) conducted an observational in Acute coronary syndrome (n=7,930). First presentation acute myocardial infarction vs. History of acute coronary syndrome was evaluated on overall mortality (OR 1.16, 95% CI 0.74-1.83). First presentation acute myocardial infarction was associated with an odds ratio of 1.16 (95% CI 0.74-1.83) for overall mortality compared to patients with a history of acute coronary syndrome.
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