Advertisement

 

 

Clinical outcomes according to symptom presentation in patients with acute myocardial infarction: Results from the FAST-MI 2010 registry.

Clinical outcomes according to symptom presentation in patients with acute myocardial infarction: Results from the FAST-MI 2010 registry.
Author Information (click to view)

Puymirat E, Aissaoui N, Bonello L, Cayla G, Labèque JN, Nallet O, Motreff P, Varenne O, Schiele F, Ferrières J, Simon T, Danchin N, ,


Puymirat E, Aissaoui N, Bonello L, Cayla G, Labèque JN, Nallet O, Motreff P, Varenne O, Schiele F, Ferrières J, Simon T, Danchin N, , (click to view)

Puymirat E, Aissaoui N, Bonello L, Cayla G, Labèque JN, Nallet O, Motreff P, Varenne O, Schiele F, Ferrières J, Simon T, Danchin N, ,

Advertisement
Share on FacebookTweet about this on TwitterShare on LinkedIn

Clinical cardiology 2017 12 15() doi 10.1002/clc.22819
Abstract
BACKGROUND
Atypical clinical presentation in acute myocardial infarction (AMI) patients is not uncommon; most studies suggest that it is associated with unfavorable prognosis.

HYPOTHESIS
Long-term clinical impact differs according to predominant symptom presentation (typical chest pain, atypical chest pain, syncope, cardiac arrest, or dyspnea) in AMI patients.

METHODS
FAST-MI 2010, a nationwide French registry, included 4169 patients with AMI in 213 centers at the end of 2010 (76% of active centers). Demographics, medical history, hospital management, and outcomes were compared according to predominant symptom presentation.

RESULTS
Typical chest pain with no other symptom was reported in 3020 patients (68% in STEMI patients, 76% in NSTEMI patients). Atypical chest pain, dyspnea, syncope, and cardiac arrest were reported in 11%, 11%, 5%, and 1%, respectively. Patients with atypical clinical presentation had a higher cardiovascular risk profile and received fewer medications and a less invasive strategy. Using Cox multivariate analysis, atypical chest pain was not associated with higher death rate at 3 years (HR: 0.96, 95% CI: 0.69-1.33, P = 0.78), whereas cardiac arrest (HR: 2.44, 95% CI: 1.00-5.97, P = 0.05), syncope (HR: 1.70, 95% CI: 1.18-2.46, P = 0.005), and dyspnea (HR: 1.66, 95% CI: 1.31-2.10, P < 0.001) were associated with higher long-term mortality compared with patients with typical isolated chest pain. Similar trends were observed in STEMI and NSTEMI populations. CONCLUSIONS
Atypical clinical presentation is observed in about 20% of AMI patients. Cardiac arrest, dyspnea, and syncope represent independent predictors of long-term mortality in STEMI and NSTEMI populations.

Submit a Comment

Your email address will not be published. Required fields are marked *

two × 2 =

[ HIDE/SHOW ]