Article

This study examined
the frequency of symptom mismatch, which factors are associated with a symptom
mismatch and how symptom mismatch is related to 28-day case fatality. DESIGN:
Observational study.
METHODS: The sample consisted of 1282 persons with a first
and recurrent AMI, recruited from a population-based AMI registry, 1985-2011.
Occurrence of 11 symptoms was recorded in first and recurrent AMI using
standardized patient interview. Logistic regression modelling adjusted for
demographic and clinical variables was applied.
RESULTS: Mismatch was highest for
dyspnoea (40.6%) and lowest for chest symptoms (10.4%). Compared with women, men
were less likely to have a mismatch of pain between the shoulder blades (odds
ratio (OR) 0.58, 95% confidence interval (CI) 0.43-0.79), pain in the throat/jaw
(OR 0.67, 95% CI 0.50-0.91), nausea (OR 0.62, 95% CI 0.47-0.82), vomiting (OR
0.50, 95% CI 0.36-0.71), or fear of death (OR 0.71, 95% CI 0.53-0.94), or to have
three or more mismatching symptoms (OR 0.60, 95% CI 0.45-0.79). Persons with
diabetes were more likely to have a mismatch in chest symptoms, whereas persons
with hyperlipidaemia or persons who received any revascularization therapy at
first infarction were significantly less likely to have a mismatch of chest
symptoms. Twenty-eight-day case fatality significantly increased with the number
of mismatching symptoms (OR 1.14, 95% CI 1.02-1.28). CONCLUSIONS: Patients with
AMI may benefit from information about the possibility that a recurrent infarction may be associated with different symptoms.
CI - (c) The European Society of Cardiology 2015.

Langue : ANGLAIS