Clinical and Coronary Disease Characteristics Among Patients With ST-segment Elevation Myocardial Infarction and Without Typical Chest Pain
10.3969/j.issn.1000-3614.2018.06.002
- VernacularTitle:中国无典型胸痛ST段抬高型心肌梗死患者的临床特征和冠状动脉病变特征分析
- Author:
Rui FU
1
;
Chen-Xi SONG
;
Jin-Gang YANG
;
Hai-Yan XU
;
Xiao-Jin GAO
;
Wei LI
;
Ke-Fei DOU
;
Yue-Jin YANG
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病诊治中心
- Keywords:
Myocardial infarction;
Atypical chest pain;
Coronary angiography;
In-hospital mortality
- From:
Chinese Circulation Journal
2018;33(6):524-528
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:To explore the clinical and coronary disease characteristics and prognosis of Chinese patients with ST segment elevation myocardial infarction and without typical chest pain. Methods:By extracting data from China Acute Myocardial Infarction Registry, we included 12 145 STEMI patients who underwent coronary angiography between 01 January 2013 to 30 September 2014. Variables of interest were extracted and compared between AMI patients without vs with typical chest pain. Multivariable logistic regression analysis was used to identify independent predictors of in-hospital mortality. Results:There were approximately 24% (2922/12145) STEMI patients without typical chest pain. Compared with typical chest pain patients, patients without typical chest pain had higher prevalence of diabetes (20.0% vs 17.8%), longer time of disease onset to hospital, lower rate of IRA disease of left anterior descending artery (44.6% vs 51.2%). These patients were less likely to receive primary percutaneous coronary intervention (64.9% vs 73.9%) and had higher in-hospital mortality (3.3% vs 2.2%, P＜0.05). Multivarite Logistic regression analysis indicated atypical chest pain was an independent risk factor for in-hospital death (OR:1.364, 95% confidence interval:1.018-1.827). Conclusions:Approximately a quarter STEMI patients presented without typical chest pain in this patient cohort and they had longer disease onset to hospital time, were less likely to receive PCI, and associated with higher in-hospital mortality risk. Efforts should be made to identify these patients in order to apply the optimal treatments to them.
