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Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry

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Author(s)
Jun-Won LeeJin Sil MoonDae Ryong KangSang Jun LeeJung-Woo SonYoung Jin YounSung Gyun AhnMin-Soo AhnJang-Young KimByung-Su YooSeung-Hwan LeeJu Han KimMyung Ho JeongJong-Seon ParkShung Chull ChaeSeung Ho HurMyeng-Chan ChoSeung Woon RhaKwang Soo ChaJei Keon ChaeDong-Ju ChoiIn Whan SeongSeok Kyu OhJin Yong HwangJunghan Yoon
Keimyung Author(s)
Hur, Seung Ho
Department
Dept. of Internal Medicine (내과학)
Journal Title
Journal of clinical medicine
Issued Date
2020
Volume
9
Issue
2
Keyword
chest paindiabetesmyocardial infarction
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.
Keimyung Author(s)(Kor)
허승호
Publisher
School of Medicine (의과대학)
Citation
Jun-Won Lee et al. (2020). Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial Infarction from Prospective KAMIR-NIH Registry. Journal of clinical medicine, 9(2), 505–519. doi: 10.3390/jcm9020505
Type
Article
ISSN
2077-0383
Source
https://www.mdpi.com/2077-0383/9/2/505
DOI
10.3390/jcm9020505
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/43145
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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