Key result
Diabetes was not an independent predictor of atypical symptoms during a first myocardial infarction, with typical symptoms reported by 90.1% of patients with diabetes and 91.5% without.
Why the study?
Are patients with diabetes more likely to present with atypical symptoms during a first myocardial infarction compared to those without diabetes?
Observational (n=4,028)
Yes
Are patients with diabetes more likely to present with atypical symptoms during a first myocardial infarction compared to those without diabetes?
Absolute Event Rate: 90.1% vs 91.5%
Contrary to common clinical teaching, patients with diabetes are not more likely to present with atypical symptoms during a first myocardial infarction.
Challenges common teaching on atypical MI symptoms in diabetes; leaves open validation in diverse cohorts and impact on recognition.
AIM: To describe symptoms of a first myocardial infarction in men and women with and without diabetes. METHODS: We conducted a population-based study of 4028 people aged 25-74 years, with first myocardial infarction registered in the Northern Sweden Multinational MONItoring of trends and determinants in CArdiovascular disease (MONICA) myocardial infarction registry between 2000 and 2006. Symptoms were classified as typical or atypical according to the World Health Organization MONICA manual. RESULTS: Among patients with diabetes, 90.1% reported typical symptoms of myocardial infarction; the corresponding proportion among patients without diabetes was 91.5%. In the diabetes group, 88.8% of women and 90.8% of men had typical symptoms of myocardial infarction. No differences were found in symptoms of myocardial infarction between women with and without diabetes or between men with and without diabetes. Atypical symptoms were more prevalent in the older age groups (> 65 years) than in the younger age groups (< 65 years). The increases were approximately equal among men and women, with and without diabetes. Diabetes was not an independent predictor for having atypical symptoms of myocardial infarction. CONCLUSIONS: Typical symptoms of myocardial infarction were equally prevalent in patients with and without diabetes and there were no sex differences in symptoms among persons with diabetes. Diabetes was not a predictor of atypical symptoms.
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Ängerud et al. (2011) conducted an observational in first myocardial infarction (n=4,028). Diabetes vs. No diabetes was evaluated on Typical symptoms of myocardial infarction. Diabetes was not an independent predictor of atypical symptoms during a first myocardial infarction, with typical symptoms reported by 90.1% of patients with diabetes and 91.5% without.
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