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Clinical Impact of Atypical Chest Pain and Diabetes Mellitus in Patients with Acute Myocardial ...
  • Date2021-02-23 17:57
  • Update2021-02-23 17:57
  • CountersignatureDivision of Research Planning
  • Tel043-719-8033

Journal of Clinical Medicine, 2020.9(2), 505-0, DOI: https://doi.org/10.3390/jcm9020505


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

Jun-Won Lee, Dae Ryong Kang; Sang Jun Lee; Jung-Woo Son; Young Jin Youn; Sung Gyun Ahn; Min-Soo Ahn; Jang-Young Kim; Byung-Su Yoo; Seung-Hwan Lee; Ju Han Kim; Myung Ho Jeong; Jong-Seon Park; Shung Chull Chae; Seung Ho Hur; Myeng-Chan Cho; Seung Woon Rha; Kwang Soo Cha; Jei Keon Chae; Dong-Ju Choi; In Whan Seong; Seok Kyu Oh; Jin Yong Hwang; Junghan Yoon


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.



  • 본 연구는 질병관리본부 연구개발과제연구비를 지원받아 수행되었습니다.
  • This research was supported by a fund by Research of Korea Centers for Disease Control and Prevention.


This public work may be used under the terms of the public interest source This public work may be used under the terms of the public interest source
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