Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study
Why the study?
It was unknown whether an association exists between prehospital chest pain severity and markers of myocardial injury.
Does pre-hospital chest pain severity correlate with myocardial injury in patients with STEMI?
Population
414 patients with confirmed STEMI treated by emergency medical services
Comparison
Moderate to severe chest pain (pain ≥ 5/10) vs less than moderate severity
Design
Post-hoc retrospective cohort analysis of the AVOID study
Follow-up
6 months
Authors
Discussion
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Member takes
Implication
Weak/no association between prehospital pain severity and myocardial injury markers in STEMI; hypothesis-generating and should not yet change triage.
Structured PICO
Does pre-hospital chest pain severity correlate with myocardial injury in patients with STEMI?
P
Population
414 patients with confirmed ST elevation myocardial infarction (STEMI) treated by emergency medical services
I
Intervention
Moderate to severe pre-hospital chest pain (numerical rating scale pain ≥ 5/10)
C
Comparator
Less than moderate pre-hospital chest pain severity
O
Outcome
Association of pre-hospital initial chest pain severity, cardiac biomarkers and infarct size based on cardiac magnetic resonance imagingsurrogate
Pre-hospital chest pain severity is not independently associated with markers of myocardial injury in STEMI, supporting judicious use of opioid analgesia focused on patient comfort rather than as a proxy for infarct size.
Cite This Study
Fernando et al. (2021) studied this question.