Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis
| العنوان: | Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis |
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| المؤلفون: | Lindahl, Bertil, 1957, Ljung, L., Herlitz, J., Alfredsson, J., Erlinge, D., Kellerth, T., Omerovic, E., Ravn-Fischer, A., Sparv, D., Yndigegn, T., Svensson, P., Östlund, Olof Petter, Jernberg, T., James, Stefan, 1964, Hofmann, R. |
| المصدر: | Journal of Internal Medicine. 290(2):359-372 |
| مصطلحات موضوعية: | acute myocardial infarction, cardiovascular clinical research, cardiovascular risk factors, chest pain, noncardiac chest pain, randomized clinical trial |
| الوصف: | Background Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis.Methods The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1-3.7 years) irrespective of randomized treatment.Results 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF.Conclusions Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis. |
| وصف الملف: | electronic |
| الوصول الحر: | https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-454212Test https://doi.org/10.1111/joim.13272Test https://uu.diva-portal.org/smash/get/diva2:1597654/FULLTEXT01.pdfTest |
| قاعدة البيانات: | SwePub |
| تدمد: | 20180187 |
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| DOI: | 10.1111/joim.13272 |