Key result
The presence of typical chest pain symptoms at the time of acute myocardial infarction was associated with a significantly reduced risk of 28-day mortality (OR 0.40) compared to patients without typical chest pain.
Why the study?
The study investigated various acute myocardial infarction symptoms and their associations with short-term (28 day) and long-term mortality.
Does the presence of specific acute myocardial infarction symptoms predict short- and long-term mortality in patients with first-time AMI?
Cohort (n=5,900)
Yes
Does the presence of specific acute myocardial infarction symptoms predict short- and long-term mortality in patients with first-time AMI?
Atypical presentation of acute myocardial infarction, particularly the absence of chest pain and the presence of shortness of breath, is associated with significantly higher short- and long-term mortality.
Answers are grounded in this paper and cite their sources.
Atypical AMI presentations may identify higher short-term mortality risk; leaves open whether symptom data refines existing risk models.
BACKGROUND: In this study, we investigated various acute myocardial infarction (AMI) symptoms and their associations with short-term (28 day) and long-term mortality. METHODS: The analysis was based on 5900 patients, aged 25 to 84 years, with first-time AMI recorded by the population-based Myocardial Infarction Registry Augsburg between 2010 and 2017. Median follow-up time was 3.8 years (interquartile range: 1.1-6.3). As part of a face-to-face interview, the presence (yes/no) of 11 most common AMI symptoms at the acute event was assessed. Using multivariable-adjusted logistic regression and Cox regression models, the association between various symptoms and all-cause mortality was investigated. P values of the regression models were false discovery rate adjusted. RESULTS: Pain in various body parts (chest pain, left and right shoulder/arm/hand, between shoulder blades), sweating, nausea/vomiting, dizziness and fear of death/feeling of annihilation were significantly associated with a decreased 28-day mortality after AMI. The pain symptoms and sweating were also significantly associated with a decreased long-term mortality. Shortness of breath was significantly associated with a higher long-term mortality. CONCLUSIONS: The absence of several symptoms, including typical chest discomfort (chest pain or retrosternal pressure/tightness), is associated with unfavourable outcomes after AMI. This finding has implications for patient management and public health measures designed to encourage appropriate and prompt medical consultation of patients with atypical AMI symptoms.
No takes yet. Share an insight, caveat, or question.
Schmitz et al. (2024) conducted a cohort in Acute Myocardial Infarction (n=5,900). Presence of typical chest pain symptoms vs. Absence of typical chest pain symptoms was evaluated on 28-day all-cause mortality (OR 0.40, 95% CI 0.32-0.51, p=<0.001). The presence of typical chest pain symptoms at the time of acute myocardial infarction was associated with a significantly reduced risk of 28-day mortality (OR 0.40) compared to patients without typical chest pain.
Synapse has enriched 5 closely related papers on similar clinical questions. Consider them for comparative context: