Non-Chest Pain Presentation Doesn't Worsen MI Outcomes
Similar outcomes as those who present with chest pain despite delays in diagnosis and reperfusion
TUESDAY, Dec. 30, 2014 (HealthDay News) -- Among patients with acute ST-elevation myocardial infarction (STEMI), presentation with non-chest pain delays door-to-balloon (DTB) time but does not worsen clinical outcomes, according to research published in the Dec. 15 issue of The American Journal of Cardiology.
Jin Sup Park, M.D., of Pusan National University Hospital in Busan, South Korea, and colleagues conducted a prospective observational study of matched cohorts, undergoing primary percutaneous coronary intervention for STEMI, who presented with chest pain or non-chest pain complaints (976 patients each). The effect of non-chest pain complaints on DTB time and clinical outcomes was assessed.
The researchers found that patients with non-chest pain complaints, compared with those with chest pain, experienced significant delays in DTB time (median, 84 versus 74 minutes, respectively; P < 0.001). In multivariate models, non-chest pain complaints independently predicted DTB time. Clinical outcomes, including in-hospital mortality (adjusted hazard ratio [aHR], 1.402; 95 percent confidence interval [CI], 0.727 to 2.705; P = 0.313), all-cause mortality (aHR, 1.175; 95 percent CI, 0.453 to 3.853; P = 0.642), and major adverse cardiac events at follow-up (aHR, 0.139; 95 percent CI, 0.876 to 1.48; P = 0.331), did not differ between the groups.
"In conclusion, short- and long-term clinical outcomes in patients with STEMI with non-chest pain complaints do not differ from those of patients with chest pain as the presenting symptom, despite having delayed diagnosis and reperfusion," the authors write.