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Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry

Atypical chest pain and diabetic autonomic neuropathy attract less clinical attention, leading to underdiagnosis and delayed treatment. To evaluate the long-term clinical impact of atypical chest pain and diabetes mellitus (DM), we categorized 11,159 patients with acute myocardial infarction (AMI) f...

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Autores principales: Lee, Jun-Won, Moon, Jin Sil, Kang, Dae Ryong, Lee, Sang Jun, Son, Jung-Woo, Youn, Young Jin, Ahn, Sung Gyun, Ahn, Min-Soo, Kim, Jang-Young, Yoo, Byung-Su, Lee, Seung-Hwan, Kim, Ju Han, Jeong, Myung Ho, Park, Jong-Seon, Chae, Shung Chull, Hur, Seung Ho, Cho, Myeng-Chan, Rha, Seung Woon, Cha, Kwang Soo, Chae, Jei Keon, Choi, Dong-Ju, Seong, In Whan, Oh, Seok Kyu, Hwang, Jin Yong, Yoon, Junghan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074023/
https://www.ncbi.nlm.nih.gov/pubmed/32059609
http://dx.doi.org/10.3390/jcm9020505
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author Lee, Jun-Won
Moon, Jin Sil
Kang, Dae Ryong
Lee, Sang Jun
Son, Jung-Woo
Youn, Young Jin
Ahn, Sung Gyun
Ahn, Min-Soo
Kim, Jang-Young
Yoo, Byung-Su
Lee, Seung-Hwan
Kim, Ju Han
Jeong, Myung Ho
Park, Jong-Seon
Chae, Shung Chull
Hur, Seung Ho
Cho, Myeng-Chan
Rha, Seung Woon
Cha, Kwang Soo
Chae, Jei Keon
Choi, Dong-Ju
Seong, In Whan
Oh, Seok Kyu
Hwang, Jin Yong
Yoon, Junghan
author_facet Lee, Jun-Won
Moon, Jin Sil
Kang, Dae Ryong
Lee, Sang Jun
Son, Jung-Woo
Youn, Young Jin
Ahn, Sung Gyun
Ahn, Min-Soo
Kim, Jang-Young
Yoo, Byung-Su
Lee, Seung-Hwan
Kim, Ju Han
Jeong, Myung Ho
Park, Jong-Seon
Chae, Shung Chull
Hur, Seung Ho
Cho, Myeng-Chan
Rha, Seung Woon
Cha, Kwang Soo
Chae, Jei Keon
Choi, Dong-Ju
Seong, In Whan
Oh, Seok Kyu
Hwang, Jin Yong
Yoon, Junghan
author_sort Lee, Jun-Won
collection PubMed
description Atypical chest pain and diabetic autonomic neuropathy attract less clinical attention, leading to underdiagnosis and delayed treatment. To evaluate the long-term clinical impact of atypical chest pain and diabetes mellitus (DM), we categorized 11,159 patients with acute myocardial infarction (AMI) from the Korea AMI-National Institutes of Health between November 2011 and December 2015 into four groups (atypical DM, atypical non-DM, typical DM, and typical non-DM). The primary endpoint was defined as patient-oriented composite endpoint (POCE) at 2 years including all-cause death, any myocardial infarction (MI), and any revascularization. Patients with atypical chest pain showed higher 2-year mortality than those with typical chest pain in both DM (29.5% vs. 11.4%, p < 0.0001) and non-DM (20.4% vs. 6.3%, p < 0.0001) groups. The atypical DM group had the highest risks of POCE (hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.48–2.10), all-cause death (HR 2.23, 95% CI 1.80–2.76) and any MI (HR 2.34, 95% CI 1.51–3.64) in the adjusted model. In conclusion, atypical chest pain was significantly associated with mortality in patients with AMI. Among four groups, the atypical DM group showed the worst clinical outcomes at 2 years. Application of rapid rule in/out AMI protocols would be beneficial to improve clinical outcomes.
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spelling pubmed-70740232020-03-19 Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry Lee, Jun-Won Moon, Jin Sil Kang, Dae Ryong Lee, Sang Jun Son, Jung-Woo Youn, Young Jin Ahn, Sung Gyun Ahn, Min-Soo Kim, Jang-Young Yoo, Byung-Su Lee, Seung-Hwan Kim, Ju Han Jeong, Myung Ho Park, Jong-Seon Chae, Shung Chull Hur, Seung Ho Cho, Myeng-Chan Rha, Seung Woon Cha, Kwang Soo Chae, Jei Keon Choi, Dong-Ju Seong, In Whan Oh, Seok Kyu Hwang, Jin Yong Yoon, Junghan J Clin Med Article Atypical chest pain and diabetic autonomic neuropathy attract less clinical attention, leading to underdiagnosis and delayed treatment. To evaluate the long-term clinical impact of atypical chest pain and diabetes mellitus (DM), we categorized 11,159 patients with acute myocardial infarction (AMI) from the Korea AMI-National Institutes of Health between November 2011 and December 2015 into four groups (atypical DM, atypical non-DM, typical DM, and typical non-DM). The primary endpoint was defined as patient-oriented composite endpoint (POCE) at 2 years including all-cause death, any myocardial infarction (MI), and any revascularization. Patients with atypical chest pain showed higher 2-year mortality than those with typical chest pain in both DM (29.5% vs. 11.4%, p < 0.0001) and non-DM (20.4% vs. 6.3%, p < 0.0001) groups. The atypical DM group had the highest risks of POCE (hazard ratio (HR) 1.76, 95% confidence interval (CI) 1.48–2.10), all-cause death (HR 2.23, 95% CI 1.80–2.76) and any MI (HR 2.34, 95% CI 1.51–3.64) in the adjusted model. In conclusion, atypical chest pain was significantly associated with mortality in patients with AMI. Among four groups, the atypical DM group showed the worst clinical outcomes at 2 years. Application of rapid rule in/out AMI protocols would be beneficial to improve clinical outcomes. MDPI 2020-02-12 /pmc/articles/PMC7074023/ /pubmed/32059609 http://dx.doi.org/10.3390/jcm9020505 Text en © 2020 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Lee, Jun-Won
Moon, Jin Sil
Kang, Dae Ryong
Lee, Sang Jun
Son, Jung-Woo
Youn, Young Jin
Ahn, Sung Gyun
Ahn, Min-Soo
Kim, Jang-Young
Yoo, Byung-Su
Lee, Seung-Hwan
Kim, Ju Han
Jeong, Myung Ho
Park, Jong-Seon
Chae, Shung Chull
Hur, Seung Ho
Cho, Myeng-Chan
Rha, Seung Woon
Cha, Kwang Soo
Chae, Jei Keon
Choi, Dong-Ju
Seong, In Whan
Oh, Seok Kyu
Hwang, Jin Yong
Yoon, Junghan
Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title_full Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title_fullStr Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title_full_unstemmed Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title_short Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
title_sort clinical impact of atypical chest pain and diabetes mellitus in patients with acute myocardial infarction from prospective kamir-nih registry
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7074023/
https://www.ncbi.nlm.nih.gov/pubmed/32059609
http://dx.doi.org/10.3390/jcm9020505
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