Comparison of Outcomes of Patients With Painless Versus Painful ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention
- Authors
- Cho, Jae Yeong; Jeong, Myung Ho; Ahn, Young Keun; Kim, Jong Hyun; Chae, Shung Chu; Kim, Young Jo; Hur, Seung Ho; Seong, In Whan; Hong, Taek Jong; Choi, Dong Hoon; Cho, Myeong Chan; Kim, Chong Jin; Seung, Ki Bae; Chung, Wook Sung; Jang, Yang Soo; Cho, Seung Yun; Rha, Seung Woon; Bae, Jong Ho; Cho, Jeong Gwan; Park, Seung Jung
- Issue Date
- 1-2월-2012
- Publisher
- EXCERPTA MEDICA INC-ELSEVIER SCIENCE INC
- Citation
- AMERICAN JOURNAL OF CARDIOLOGY, v.109, no.3, pp.337 - 343
- Indexed
- SCIE
SCOPUS
- Journal Title
- AMERICAN JOURNAL OF CARDIOLOGY
- Volume
- 109
- Number
- 3
- Start Page
- 337
- End Page
- 343
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/106083
- DOI
- 10.1016/j.amjcard.2011.09.017
- ISSN
- 0002-9149
- Abstract
- There are few data available on the prognosis of painless ST-segment elevation myocardial infarction (STEMI). The aim of this study was to determine the incidence, clinical characteristics, and outcomes of painless STEMI. We analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) study, which enrolled 7,288 patients with STEMI (61.8 +/- 12.8 years old, 74% men; painless STEMI group, n = 763; painful STEMI group, n = 6,525). End points were in-hospital mortality and 1-year major adverse cardiac events (MACEs). Patients with painless STEMI were older and more likely to be women, nonsmokers, diabetic, and normolipidemic and to have a higher Killip class. The painless group had more in-hospital deaths (5.9% vs 3.6%, p = 0.026) and 1-year MACEs (26% vs 19%, p = 0.002). In Cox proportional hazards analysis, hypotension (hazard ratio [HR] 4.40, 95% confidence interval [CI] 1.41 to 13.78, p = 0.011), low left ventricular ejection fraction (HR 3.12, 95% CI 1.21 to 8.07, p = 0.019), and a high Killip class (HR 3.48, 95% CI 1.19 to 10.22, p = 0.023) were independent predictors of 1-year MACEs in patients with painless STEMI. In conclusion, painless STEMI was associated with more adverse outcomes than painful STEMI and late detection may have contributed significantly to total ischemic burden. These results warrant more investigations for methodologic development in the diagnosis of silent ischemia and painless STEMI. (C) 2012 Elsevier Inc. All rights reserved. (Am J Cardiol 2012;109:337-343)
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