Atypical symptom cluster predicts a higher mortality in patients with first-time acute myocardial infarction

Seon Young Hwang, Young Geun Ahn, Myung Ho Jeong

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Background and Objectives: Identifying symptom clusters of acute myocardial infarction (AMI) and their clinical significance may be useful in guiding treatment seeking behaviors and in planning treatment strategy. The aim of this study was to identify clusters of acute symptoms and their associated factors that manifested in patients with first-time AMI, and to compare clinical outcomes among cluster groups within 1-year of follow-up. Subjects and Methods: A total of 391 AMI patients were interviewed individually using a structured questionnaire for acute and associated symptoms between March 2008 and June 2009 in Korea. Results: Among 14 acute symptoms, three distinct clusters were identified by Latent Class Cluster Analysis: typical chest symptom (57.0%), multiple symptom (27.9%), and atypical symptom (15.1%) clusters. The cluster with atypical symptoms was characterized by the least chest pain (3.4%) and moderate frequencies (31-61%) of gastrointestinal symptoms, weakness or fatigue, and shortness of breath; they were more likely to be older, diabetic and to have worse clinical markers at hospital presentation compared with those with other clusters. Cox proportional hazards regression analysis showed that, when age and gender were adjusted for, the atypical symptom cluster significantly predicted a higher risk of 1-year mortality compared to the typical chest pain cluster (hazard ratio 3.288, 95% confidence interval 1.087-9.943, p=0.035). Conclusion: Clusters of symptoms can be utilized in guiding a rapid identification of symptom patterns and in detecting higher risk patients. Intensive treatment should be considered for older and diabetic patients with atypical presentation.

Original languageEnglish
Pages (from-to)16-22
Number of pages7
JournalKorean Circulation Journal
Volume42
Issue number1
DOIs
StatePublished - 2012 Jan 1

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Myocardial Infarction
Mortality
Chest Pain
Korea
Dyspnea
Fatigue
Cluster Analysis
Thorax
Therapeutics
Biomarkers
Regression Analysis
Confidence Intervals

Keywords

  • Acute coronary syndrome
  • Acute myocardial infarction
  • Cluster analysis
  • Symptom

Cite this

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abstract = "Background and Objectives: Identifying symptom clusters of acute myocardial infarction (AMI) and their clinical significance may be useful in guiding treatment seeking behaviors and in planning treatment strategy. The aim of this study was to identify clusters of acute symptoms and their associated factors that manifested in patients with first-time AMI, and to compare clinical outcomes among cluster groups within 1-year of follow-up. Subjects and Methods: A total of 391 AMI patients were interviewed individually using a structured questionnaire for acute and associated symptoms between March 2008 and June 2009 in Korea. Results: Among 14 acute symptoms, three distinct clusters were identified by Latent Class Cluster Analysis: typical chest symptom (57.0{\%}), multiple symptom (27.9{\%}), and atypical symptom (15.1{\%}) clusters. The cluster with atypical symptoms was characterized by the least chest pain (3.4{\%}) and moderate frequencies (31-61{\%}) of gastrointestinal symptoms, weakness or fatigue, and shortness of breath; they were more likely to be older, diabetic and to have worse clinical markers at hospital presentation compared with those with other clusters. Cox proportional hazards regression analysis showed that, when age and gender were adjusted for, the atypical symptom cluster significantly predicted a higher risk of 1-year mortality compared to the typical chest pain cluster (hazard ratio 3.288, 95{\%} confidence interval 1.087-9.943, p=0.035). Conclusion: Clusters of symptoms can be utilized in guiding a rapid identification of symptom patterns and in detecting higher risk patients. Intensive treatment should be considered for older and diabetic patients with atypical presentation.",
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Atypical symptom cluster predicts a higher mortality in patients with first-time acute myocardial infarction. / Hwang, Seon Young; Ahn, Young Geun; Jeong, Myung Ho.

In: Korean Circulation Journal, Vol. 42, No. 1, 01.01.2012, p. 16-22.

Research output: Contribution to journalArticle

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