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Presenting Symptoms Do Not Predict NSTEMI Outcomes

Presenting symptoms, such as chest pain, dyspnea/fatigue, syncope were not independent predictors of death from any cause at one year

THURSDAY, March 24, 2022 (HealthDay News) — Although the survival rate at one year was lower among patients with non-ST-segment elevation myocardial infarction (NSTEMI) who experienced dyspnea/fatigue, presenting symptoms are not independent predictors of mortality, according to a study presented at ESC Acute CardioVascular Care 2022, held virtually from March 18 to 19.

Paulo Araujo Leite Medeiros, from the Hospital de Braga in Portugal, and colleagues examined the outcomes of NSTEMI patients according to their presenting symptoms. Data were included for 4,726 patients older than 18 years admitted between October 2010 and September 2019. The patients were divided according to the main presentation symptom: chest pain; dyspnea/fatigue; and syncope (groups 1, 2, and 3, respectively).

The researchers found that the most common symptom at presentation was chest pain, followed by dyspnea/fatigue and syncope (91.3, 7.0, and 1.7 percent, respectively). Patients presenting with dyspnea/fatigue were older and more commonly women, and a greater proportion had hypertension, diabetes mellitus, chronic kidney disease, and chronic obstructive pulmonary disease. Patients presenting with dyspnea/fatigue had the lowest one-year survival rate (75.7 percent versus 93.5 and 92.1 percent for groups 1 and 3, respectively) and the lowest one-year free from cardiovascular rehospitalization (75.6 percent versus 85.0 and 83.3 percent for groups 1 and 3, respectively). After a multivariate analysis, presenting symptoms were not significant independent predictors of the primary end point of one-year death from any cause.

“When considering all of the studied variables, the type of presenting symptom was not an independent predictor of mortality, meaning that we cannot specifically state that shortness of breath was the reason for the worse outcome,” Medeiros said in a statement.

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