Key result
Diabetic STEMI patients did not arrive significantly later to the emergency room than non-diabetics (p=0.105), but reported significantly less pain and more shortness of breath (p<0.01).
Why the study?
Does diabetes type 2 alter hospital arrival time and pain presentation in patients with first presentation of STEMI?
Observational (n=266)
Does diabetes type 2 alter hospital arrival time and pain presentation in patients with first presentation of STEMI?
Diabetic STEMI patients present with atypical symptoms such as shortness of breath and less severe pain compared to non-diabetics, highlighting the need for cautious clinical evaluation to avoid delays in care.
Answers are grounded in this paper and cite their sources.
Supports awareness of atypical diabetic STEMI symptoms without later presentation; extends prior observations to first-presentation cohorts.
The aim of our study was to determine whether diabetic ST segment elevation myocardial infarction (STEMI) patients arrive in the emergency room (ER) later than non-diabetics, compare the differences in pain quality and quantity between those groups, and measure differences in the outcome after an index hospitalization. A total of 266 patients with first presentation of STEMI were included in our study during a period of two years, 62 with diabetes and 204 without diabetes type 2. Pain intensity and quality at admission were measured using a McGill short form questionnaire. Diabetic patients did not arrive significantly later than non-diabetic (χ²; p = 0.105). Most diabetic patients described their pain as "slight" or "none" (χ²; p < 0.01), while most non-diabetic patients graded their pain as "moderate" or "severe" (χ²; p < 0.01). The quality of pain tended to be more distinct in non-diabetic patients, while diabetic patients reported mainly shortness of breath (χ²; p < 0.01). Diabetic patients were more likely to suffer a multi-vessel disease (χ²; p < 0.01), especially in the late arrival group. Therefore, cautious evaluation of diabetic patients and adequate education of target population could improve overall survival while well-organized care like a primary PCI Network program could significantly reduce CV mortality.
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Gradišer et al. (2015) conducted an observational in ST segment elevation myocardial infarction (STEMI) (n=266). Diabetes vs. No diabetes was evaluated on Hospital arrival time (p=0.105). Diabetic STEMI patients did not arrive significantly later to the emergency room than non-diabetics (p=0.105), but reported significantly less pain and more shortness of breath (p<0.01).
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