Document Detail


Presenting symptoms of myocardial infarction predict short- and long-term mortality: The MONICA/KORA Myocardial Infarction Registry.
MedLine Citation:
PMID:  23194485     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: It is unknown whether clinical outcomes differ with specific symptoms of an acute myocardial infarction (AMI). The objective of this study was to investigate the association between 13 self-reported symptoms and 28-day case fatality or long-term all-cause mortality in patients with AMI.
METHODS: The sample consisted of 1,231 men and 415 women aged 25 to 74 years hospitalized with a first-time AMI recruited from a population-based AMI registry. Multivariable logistic regression modeling was used to assess the relationship between symptom occurrence and 28-day case fatality. Cox proportional hazards models were used to determine the effects on long-term mortality. Analyses were adjusted for sex, age, type of AMI, diabetes, prehospital delay time, and reperfusion therapy.
RESULTS: The median observation time was 4.1 years (interquartile range 15 years). Twenty-eight-day case fatality was 6.1%, and long-term mortality was 10.6%. Patients who experienced fear of death (odds ratio [OR] 0.11, 95% confidence interval [CI] 0.03-0.47), diaphoresis (OR 0.45, 95% CI 0.25-0.82), or nausea (OR 0.45, 95% CI 0.22-0.95) had a significantly decreased risk of dying within 28 days, whereas syncope (OR 5.36, 95% CI 2.65-10.85) was associated with a higher risk. A decreased risk for long-term mortality was found for people with pain in the upper abdomen (hazard ratio 0.43, 95% CI 0.19-0.97), whereas dyspnea was related to an increased risk (hazard ratio 1.50, 95% CI 1.11-2.06). The absence of chest symptoms was associated with a 1.85-fold risk for long-term mortality (95% CI 1.13-3.03).
CONCLUSIONS: Specific symptoms are associated with mortality. Further research is required to illuminate the reasons for this finding.
Authors:
Inge Kirchberger; Margit Heier; Bernhard Kuch; Wolfgang von Scheidt; Christa Meisinger
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  American heart journal     Volume:  164     ISSN:  1097-6744     ISO Abbreviation:  Am. Heart J.     Publication Date:  2012 Dec 
Date Detail:
Created Date:  2012-11-30     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0370465     Medline TA:  Am Heart J     Country:  United States    
Other Details:
Languages:  eng     Pagination:  856-61     Citation Subset:  AIM; IM    
Copyright Information:
Copyright © 2012 Mosby, Inc. All rights reserved.
Affiliation:
Central Hospital of Augsburg, MONICA/KORA Myocardial Infarction Registry, Augsburg, Germany; Institute of Epidemiology II, German Research Center for Environmental Health (GmbH), Helmholtz Zentrum München, Neuherberg, Germany. Electronic address: inge.kirchberger@helmholtz-muenchen.de.
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