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首页> 外文期刊>The American Journal of Cardiology >Comparison of outcomes of patients with painless versus painful ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention
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Comparison of outcomes of patients with painless versus painful ST-segment elevation myocardial infarction undergoing percutaneous coronary intervention

机译：经皮冠状动脉介入治疗无痛与痛性ST段抬高型心肌梗死患者的结局比较

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摘要

There are few data available on the prognosis of painless ST-segment elevation myocardial infarction (STEMI). The aim of this study was to determine the incidence, clinical characteristics, and outcomes of painless STEMI. We analyzed the Korea Acute Myocardial Infarction Registry (KAMIR) study, which enrolled 7,288 patients with STEMI (61.8 ± 12.8 years old, 74% men; painless STEMI group, n = 763; painful STEMI group, n = 6,525). End points were in-hospital mortality and 1-year major adverse cardiac events (MACEs). Patients with painless STEMI were older and more likely to be women, nonsmokers, diabetic, and normolipidemic and to have a higher Killip class. The painless group had more in-hospital deaths (5.9% vs 3.6%, p = 0.026) and 1-year MACEs (26% vs 19%, p = 0.002). In Cox proportional hazards analysis, hypotension (hazard ratio [HR] 4.40, 95% confidence interval [CI] 1.41 to 13.78, p = 0.011), low left ventricular ejection fraction (HR 3.12, 95% CI 1.21 to 8.07, p = 0.019), and a high Killip class (HR 3.48, 95% CI 1.19 to 10.22, p = 0.023) were independent predictors of 1-year MACEs in patients with painless STEMI. In conclusion, painless STEMI was associated with more adverse outcomes than painful STEMI and late detection may have contributed significantly to total ischemic burden. These results warrant more investigations for methodologic development in the diagnosis of silent ischemia and painless STEMI.
机译：无痛性ST段抬高型心肌梗死（STEMI）的预后数据很少。这项研究的目的是确定无痛性STEMI的发生率，临床特征和结局。我们分析了韩国急性心肌梗死登记处（KAMIR）的研究，该研究招募了7,288例STEMI患者（61.8±12.8岁，男性占74％;无痛STEMI组，n = 763;疼痛STEMI组，n = 6,525）。终点为院内死亡率和1年主要不良心脏事件（MACE）。无痛STEMI患者年龄较大，更有可能是女性，不吸烟者，糖尿病和高血脂病患者，并且具有较高的Killip等级。无痛组的院内死亡率更高（5.9％比3.6％，p = 0.026）和1年MACE（26％比19％，p = 0.002）。在Cox比例风险分析中，低血压（风险比[HR] 4.40，95％置信区间[CI] 1.41至13.78，p = 0.011），左室射血分数低（HR 3.12，95％CI 1.21至8.07，p = 0.019） ）和较高的Killip等级（HR 3.48，95％CI 1.19至10.22，p = 0.023）是无痛性STEMI患者1年MACE的独立预测因子。总之，与疼痛性STEMI相比，无痛性STEMI与更多的不良后果相关，并且延迟发现可能对总缺血负荷有显着影响。这些结果值得在无症状性缺血和无痛性STEMI诊断中进行更多方法学研究。

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