Title of article :
Comparison of Outcomes of Patients With Painless Versus Painful ST-Segment Elevation Myocardial Infarction Undergoing Percutaneous Coronary Intervention
Author/Authors :
Cho، نويسنده , , Jae Yeong and Jeong، نويسنده , , Myung Ho and Ahn، نويسنده , , Young Keun and Kim، نويسنده , , Jong Hyun and Chae، نويسنده , , Shung Chull and Kim، نويسنده , , Young Jo and Hur، نويسنده , , Seung Ho and Seong، نويسنده , , In Whan and Hong، نويسنده , , Taek Jong and Choi، نويسنده , , Dong-Hoon and Cho، نويسنده , , Myeong-Chan and Kim، نويسنده , , Chong Jin and Seung، نويسنده , , Ki Bae and Ch، نويسنده ,
Issue Information :
روزنامه با شماره پیاپی سال 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.
Journal title :
American Journal of Cardiology
Journal title :
American Journal of Cardiology