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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...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
MDPI
2020
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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. |
format | Online Article Text |
id | pubmed-7074023 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2020 |
publisher | MDPI |
record_format | MEDLINE/PubMed |
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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