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Comparison of Outcomes of Patients With Painless Versus Painful ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention

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Author(s)
허승호
Alternative Author(s)
Hur, Seung Ho
Publication Year
2012
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. © 2012 Elsevier Inc. All rights
reserved. (Am J Cardiol 2012;109:337–343)
Department
Dept. of Internal Medicine (내과학)
Publisher
School of Medicine
Citation
American Journal of Cardiology, Vol.109(3) : 337-343, 2012
Type
Article
ISSN
0002-9149
DOI
10.1016/j.amjcard.2011.09.017
URI
http://kumel.medlib.dsmc.or.kr/handle/2015.oak/34890
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