Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis?
Objective: Previous studies have discussed acute myocardial infarction (AMI) patients without chest pain, but have not focused on non-ST-elevation myocardial infarction (NSTEMI). Materials and methods: This 1-year study investigated whether chest pain presence relates to demographics, risk factors,...
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doaj-b385488657de4981bed9be8978b2508d2020-11-25T01:52:41ZengElsevierTaiwanese Journal of Obstetrics & Gynecology1028-45592019-11-01586788792Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis?Ding-Kuo Chien0Shih-Yi Lee1Chung-Lieh Hung2Fang-Ju Sun3Mau-Roung Lin4Wen-Han Chang5Department of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan; Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan; Department of Medicine, Mackay Memorial College, Taipei, TaiwanDepartment of Internal Medicine, MacKay Memorial Hospital, Taipei, TaiwanDepartment of Internal Medicine, MacKay Memorial Hospital, Taipei, TaiwanAssistant Research, Department of Medical Research, MacKay Memorial Hospital, Taipei, TaiwanGraduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, TaiwanDepartment of Emergency Medicine, MacKay Memorial Hospital, Taipei, Taiwan; Mackay Medicine, Nursing and Management College, Taipei, Taiwan; Graduate Institute of Injury Prevention and Control, Taipei Medical University, Taipei, Taiwan; Institute of Mechatronic Engineering, National Taipei University of Technology, Taipei, Taiwan; Department of Medicine, Mackay Memorial College, Taipei, Taiwan; School of Medicine, Taipei Medical University, Taipei, Taiwan; Corresponding author. No. 92, Sec. 2, Zhongshan N. Rd., Taipei City, 10449, Taiwan. Fax: +886 2 25433642.Objective: Previous studies have discussed acute myocardial infarction (AMI) patients without chest pain, but have not focused on non-ST-elevation myocardial infarction (NSTEMI). Materials and methods: This 1-year study investigated whether chest pain presence relates to demographics, risk factors, and outcomes in NSTEMI patients. We retrospectively reviewed 194 patients, 73 without chest pain vs. 121 with chest pain, and compared the differences between clinical presentations, risk factors, medical management, and outcomes of these two groups. Results: Compared to patients with chest pain, patients without chest pain were significantly older, had lower SBP, higher HR, more cerebrovascular disease, less ischemic heart disease, higher delay to ED (emergency department) visit, lower ED medication prescriptions, lower percutaneous cardiac intervention, and higher in-hospital and one-year mortality rate. In a multivariate logistic regression, the adjusted odds ratios (OR) of patients without chest pain were 4.38 for the elderly, 0.99 for every 1 mmHg increase in SBP, 1.02 for every beat/min HR increase, 0.37 for those with ischemic heart disease, and 5.09 for those with cerebrovascular disease. The adjusted OR of in-hospital mortality were 3.09 for patients without chest pain, 0.32 for those with hypertension, 0.32 for smokers, 3.98 for those with shock, and 0.16 for those with percutaneous cardiac intervention. Finally, the only significantly adjusted OR of one-year mortality was 5.37 for patients without chest pain. Conclusion: NSTEMI patients without chest pain were significantly older, had lower SBP, more tachycardia, more cerebrovascular disease, but less ischemic heart disease. They also experienced higher in-hospital and one-year mortality rates. Keywords: Non-ST-Elevation myocardial infarction (NSTEMI), Without chest-pain, Chest pain, Mortalityhttp://www.sciencedirect.com/science/article/pii/S1028455919302153 |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Ding-Kuo Chien Shih-Yi Lee Chung-Lieh Hung Fang-Ju Sun Mau-Roung Lin Wen-Han Chang |
spellingShingle |
Ding-Kuo Chien Shih-Yi Lee Chung-Lieh Hung Fang-Ju Sun Mau-Roung Lin Wen-Han Chang Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? Taiwanese Journal of Obstetrics & Gynecology |
author_facet |
Ding-Kuo Chien Shih-Yi Lee Chung-Lieh Hung Fang-Ju Sun Mau-Roung Lin Wen-Han Chang |
author_sort |
Ding-Kuo Chien |
title |
Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? |
title_short |
Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? |
title_full |
Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? |
title_fullStr |
Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? |
title_full_unstemmed |
Do patients with non-ST-elevation myocardial infarction without chest pain suffer a poor prognosis? |
title_sort |
do patients with non-st-elevation myocardial infarction without chest pain suffer a poor prognosis? |
publisher |
Elsevier |
series |
Taiwanese Journal of Obstetrics & Gynecology |
issn |
1028-4559 |
publishDate |
2019-11-01 |
description |
Objective: Previous studies have discussed acute myocardial infarction (AMI) patients without chest pain, but have not focused on non-ST-elevation myocardial infarction (NSTEMI). Materials and methods: This 1-year study investigated whether chest pain presence relates to demographics, risk factors, and outcomes in NSTEMI patients. We retrospectively reviewed 194 patients, 73 without chest pain vs. 121 with chest pain, and compared the differences between clinical presentations, risk factors, medical management, and outcomes of these two groups. Results: Compared to patients with chest pain, patients without chest pain were significantly older, had lower SBP, higher HR, more cerebrovascular disease, less ischemic heart disease, higher delay to ED (emergency department) visit, lower ED medication prescriptions, lower percutaneous cardiac intervention, and higher in-hospital and one-year mortality rate. In a multivariate logistic regression, the adjusted odds ratios (OR) of patients without chest pain were 4.38 for the elderly, 0.99 for every 1 mmHg increase in SBP, 1.02 for every beat/min HR increase, 0.37 for those with ischemic heart disease, and 5.09 for those with cerebrovascular disease. The adjusted OR of in-hospital mortality were 3.09 for patients without chest pain, 0.32 for those with hypertension, 0.32 for smokers, 3.98 for those with shock, and 0.16 for those with percutaneous cardiac intervention. Finally, the only significantly adjusted OR of one-year mortality was 5.37 for patients without chest pain. Conclusion: NSTEMI patients without chest pain were significantly older, had lower SBP, more tachycardia, more cerebrovascular disease, but less ischemic heart disease. They also experienced higher in-hospital and one-year mortality rates. Keywords: Non-ST-Elevation myocardial infarction (NSTEMI), Without chest-pain, Chest pain, Mortality |
url |
http://www.sciencedirect.com/science/article/pii/S1028455919302153 |
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