急性st段抬高型心肌梗死患者的前驱症状与求医行为

IF 2.6 3区 医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS
Akinori Tamura, Hiroki Shiomi, Takeshi Morimoto, Kazuaki Imada, Yutaka Furukawa, Yoshihisa Nakagawa, Kazushige Kadota, Natsuhiko Ehara, Ryoji Taniguchi, Jiro Sakamoto, Makoto Miyake, Toshihiro Tamura, Manabu Ogita, Satoru Suwa, Kenji Ando, Koh Ono, Takeshi Kimura
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引用次数: 0

摘要

背景:急性心肌梗死(AMI)患者发病前的前驱症状是多种多样的,并不一定局限于典型的心绞痛症状。方法:在CREDO-Kyoto AMI登记波2中登记的3959例st段抬高型心肌梗死(STEMI)患者中,在AMI发病24 h内接受了首次经皮冠状动脉介入治疗,根据患者发病前和指标就诊前48 h的症状将患者分为3组:(1)前驱症状典型的心绞痛(21.8 N = 865年  %),(2)非典型前驱症状只有(3.9 N = 156年  %),和(3)没有前驱症状(74.2 N = 2938年  %)。我们调查了前驱症状的类型与长期临床结果之间的关系,以及前驱症状的求医率。结果:与无前驱症状的患者相比,有典型前驱症状的患者死亡风险较低[校正风险比(HR): 0.69, 95 %置信区间(CI): 0.58-0.83, p = 0.0001],而有不典型前驱症状的患者死亡风险较高(HR: 1.53, 95 %CI: 1.17-2.00, p = 0.002)。在就诊行为方面,1021名有前驱症状的患者中有162人(15.9 %)因前驱症状就诊。有典型前驱症状和不典型前驱症状的患者求诊率差异无统计学意义(15.5 %和17.9 %,p = 0.44)。结论:与STEMI前无前驱症状的患者相比,具有典型前驱症状的患者长期死亡率结局较好,而具有非典型前驱症状的患者较差。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Prodromal symptoms and the care-seeking behavior in patients with acute ST-segment elevation myocardial infarction.

Background: The prodromal symptoms perceived by patients before the onset of acute myocardial infarction (AMI) are diverse and not necessarily limited to the typical symptoms of angina.

Methods: Among 3959 consecutive patients with ST-segment elevation myocardial infarction (STEMI) who underwent primary percutaneous coronary intervention within 24 h of the onset of AMI enrolled in the CREDO-Kyoto AMI registry wave-2, the patients were categorized into 3 groups by the symptoms before the onset and within 48 h before the index hospital presentation: (1) prodromal symptoms typical of angina (N = 865, 21.8 %), (2) atypical prodromal symptoms only (N = 156, 3.9 %), and (3) no prodromal symptoms (N = 2938, 74.2 %). We investigated the association between the types of the prodromal symptoms and long-term clinical outcomes as well as the prevalence of seeking medical care for the prodromal symptoms.

Results: As compared with patients with no prodromal symptoms, those with typical prodromal symptoms had a lower mortality risk [adjusted hazard ratio (HR): 0.69, 95 % confidence interval (CI): 0.58-0.83, p = 0.0001], whereas those with atypical prodromal symptoms only had a higher mortality risk (HR: 1.53, 95 % CI: 1.17-2.00, p = 0.002). Regarding healthcare-seeking behavior, 162 out of 1021 patients (15.9 %) with the prodromal symptoms sought medical care for the prodromal symptoms. There was no significant difference in the rate of seeking medical care between the patients with typical prodromal symptoms and atypical prodromal symptoms only (15.5 % and 17.9 %, p = 0.44).

Conclusions: Compared to patients with no prodromal symptoms before STEMI, long-term mortality outcome was better in patients with typical prodromal symptoms, but worse in those with atypical prodromal symptoms.

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来源期刊
Journal of cardiology
Journal of cardiology CARDIAC & CARDIOVASCULAR SYSTEMS-
CiteScore
4.90
自引率
8.00%
发文量
202
审稿时长
29 days
期刊介绍: The official journal of the Japanese College of Cardiology is an international, English language, peer-reviewed journal publishing the latest findings in cardiovascular medicine. Journal of Cardiology (JC) aims to publish the highest-quality material covering original basic and clinical research on all aspects of cardiovascular disease. Topics covered include ischemic heart disease, cardiomyopathy, valvular heart disease, vascular disease, hypertension, arrhythmia, congenital heart disease, pharmacological and non-pharmacological treatment, new diagnostic techniques, and cardiovascular imaging. JC also publishes a selection of review articles, clinical trials, short communications, and important messages and letters to the editor.
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