Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry
- Authors
- 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
- Issue Date
- 2월-2020
- Publisher
- MDPI
- Keywords
- chest pain; diabetes; myocardial infarction
- Citation
- JOURNAL OF CLINICAL MEDICINE, v.9, no.2
- Indexed
- SCIE
SCOPUS
- Journal Title
- JOURNAL OF CLINICAL MEDICINE
- Volume
- 9
- Number
- 2
- URI
- https://scholar.korea.ac.kr/handle/2021.sw.korea/57806
- DOI
- 10.3390/jcm9020505
- ISSN
- 2077-0383
- Abstract
- 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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Collections - Graduate School > Department of Biomedical Sciences > 1. Journal Articles
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