Key result
Atypical chest pain combined with diabetes mellitus in patients with acute myocardial infarction was associated with the highest risk of a 2-year composite clinical endpoint (HR 1.76; 95% CI 1.48-2.10).
Why the study?
Atypical chest pain and diabetic autonomic neuropathy attract less clinical attention, leading to underdiagnosis and delayed treatment, and their long-term clinical impact needed evaluation.
Does atypical chest pain presentation worsen long-term clinical outcomes in patients with acute myocardial infarction with or without diabetes mellitus?
Population
11,159 patients with acute myocardial infarction
Comparison
Four groups categorized by chest pain presentation (atypical vs typical) and diabetes mellitus status
Design
Prospective registry study
Follow-up
2 years
Authors
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Atypical presentations warrant heightened AMI suspicion in DM; leaves open whether neuropathy-focused protocols improve outcomes.
Cohort (n=11,159)
Yes
Does atypical chest pain presentation worsen long-term clinical outcomes in patients with acute myocardial infarction with or without diabetes mellitus?
Hazard Ratio: 1.76 (95% CI 1.48–2.1)
Atypical chest pain, particularly in patients with diabetes, is associated with significantly higher 2-year mortality and adverse cardiovascular events following acute myocardial infarction.
Lee et al. (2020) conducted a cohort in Acute myocardial infarction (n=11,159). Atypical chest pain and diabetes mellitus vs. Typical chest pain and/or no diabetes mellitus was evaluated on Patient-oriented composite endpoint (POCE) at 2 years including all-cause death, any myocardial infarction (MI), and any revascularization (HR 1.76, 95% CI 1.48-2.10). Atypical chest pain combined with diabetes mellitus in patients with acute myocardial infarction was associated with the highest risk of a 2-year composite clinical endpoint (HR 1.76; 95% CI 1.48-2.10).
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