Clinical significance of diabetes on symptom and patient delay among patients with acute myocardial infarction——an analysis from China Acute Myocardial Infarction(CAMI) registry  

作　　者：Rui FU Si-Dong LI Chen-Xi SONG Jing-Ang YANG Hai-Yan XU Xiao-Jin GAO Yi XU Jian-Ping ZENG Jun-Nong LI Ke-Fei DOU Yue-Jin YANG on behalf of the CAMI Registry study group Beijing,China 

机构地区：[1]Fuwai Hospital,National Center for Cardiovascular Diseases,Chinese Academy of Medical Sciences and Peking Union Medical College,Beijing,China [2]XiangTan Center Hospital,Xiangtan,Hunan,China [3]Department of Cardiology,Weinan Central Hospital,Weinan,Shanxi,China [4]不详

出　　处：《Journal of Geriatric Cardiology》2019年第5期395-400,共6页老年心脏病学杂志（英文版）

基　　金：supported by CAMS Innovation Fund for Medical Sciences (CIFMS) (2016-I2M-1-009);the Twelfth Five-Year Planning Project of the Scientific and Technological Department of China (2011BAI11B02);2014 Special fund for scientific research in the public interest by National Health and Family Planning Commission of the People’s Republic of China (No. 201402001)

摘　　要：Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI)patients.Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment.Few studies have reported detailed AMI symptoms in patients with diabetes.This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics.Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014.Baseline characteristics,symptomology,and delay in treatment were compared between diabetics and non-diabetics.Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms.Results A total of 4450(20.2%)patients had diabetes.They were older,more often women,higher in body mass index,and more likely to have non-ST segment elevation myocardial infarction.Fewer diabetic patients presented with persistent precordial chest pain(63.1%vs.68%,P<0.0001),diaphoresis(60.1%vs.65.6%,P<0.0001),fatigue(16.7%vs.18.3%,P=0.0123),and incontinence(0.4%vs.0.7%,P=0.0093).Time to hospital presentation was longer among patients with diabetes than those without.In multivariable analysis,diabetes was identified as an independent predictor of atypical symptoms(OR:1.112,95%CI:1.034?1.196).Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI.Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay,particularly in the context of diabetes.Background Diabetes is frequently associated with poor prognosis among acute myocardial infarction(AMI) patients. Patients with these comorbidities often have atypical symptoms and subsequent delay in treatment. Few studies have reported detailed AMI symptoms in patients with diabetes. This study compared AMI symptoms and presentation characteristics between diabetics and non-diabetics. Methods We included patients from the China AMI registry diagnosed with AMI between January 2013 and September 2014. Baseline characteristics, symptomology, and delay in treatment were compared between diabetics and non-diabetics. Multivariable logistic regression analysis was used to explore independent predictors of atypical symptoms. Results A total of 4450(20.2%) patients had diabetes. They were older, more often women, higher in body mass index, and more likely to have non-ST segment elevation myocardial infarction. Fewer diabetic patients presented with persistent precordial chest pain(63.1% vs. 68%, P < 0.0001), diaphoresis(60.1% vs. 65.6%, P < 0.0001), fatigue(16.7% vs. 18.3%, P = 0.0123), and incontinence(0.4% vs. 0.7%, P = 0.0093). Time to hospital presentation was longer among patients with diabetes than those without. In multivariable analysis, diabetes was identified as an independent predictor of atypical symptoms(OR: 1.112, 95% CI: 1.034-1.196). Conclusions Our study is the first large-scale study providing evidence that diabetics are less likely to present with typical chest pain and more likely to experience treatment delay when suffering from an AMI. Our results may increase clinician awareness of recognizing AMI patients rapidly to reduce diagnosis and treatment delay, particularly in the context of diabetes.

关 键 词：Acute myocardial INFARCTION DIABETES Symptoms Patient delay 

分 类 号：R[医药卫生]