Recognising and acting on myocardial infarction symptoms other than chest pain is linked to faster life-saving treatment, a conference is to hear.
Research from Korea, which is being presented at ESC Congress 2023 in Amsterdam, Netherlands, looked at the association between symptom recognition, time to treatment and clinical outcomes because although patients with a repeat myocardial infarction were more likely to know the symptoms than first-time sufferers, recognition was low in both groups.
Study author Dr Kyehwan Kim of Gyeongsang National University Hospital, Jinju, said: “Most patients could identify chest pain but less than one third knew the other symptoms.”
The study used data from KRAMI-RCC, a registry of myocardial infarction patients in the Republic of Korea.
It included 11,894 myocardial infarction patients, of whom 10,623 (90.4%) had a first-time event and 1,136 (9.6%) had a repeat event, of whom 1,018 patients were used in the analysis.
Trained nurses asked survivors if they recognised chest pain, shortness of breath, cold sweats, radiating pain to the jaw, shoulder or arm, dizziness/vertigo/light-headedness/loss of consciousness, and stomach ache as symptoms.
Out of all the patients, 52.3% recognised at least one symptom and were classed as “recognised symptoms”. Of these, 92.9% identified chest pain, while 32.1% recognised shortness of breath. Cold sweats were identified by 31.4% of the patients who recognised symptoms, while 27.4% recognised radiating pain. Only 7.5% identified /vertigo/light-headedness/loss of consciousness and 1.3% identified stomach ache.
Men were more likely to recognise symptoms than women at 79.3% compared to 69.0%, while individuals who were younger, had a higher education level and lived with a spouse also had higher symptom recognition.
When the researchers compared time to treatment and outcomes between the two groups, they found 57.4% of patients who correctly identified the symptoms of myocardial infarction received treatment to open the arteries and restore blood flow within two hours, compared to just 47.2% of those who did not recognise the symptoms.
Patients who recognised symptoms had a 1.5% in-hospital mortality rate compared to 6.7% of those who could not identify the symptoms of a heart attack. Individuals who could not recognise symptoms more often had cardiogenic shock and heart failure.
Another study to be presented at the ESC Congress has shown that patients who have previously had myocardial infraction who do not take daily aspirin have a higher risk of recurrent myocardial infarction, stroke or death compared with those who take the drug consistently.
Dr Anna Meta Kristensen of Bispebjerg and Frederiksberg Hospital. Frederiksberg, Denmark, and team used data from Danish nationwide health registries, which included 40,4114 patients aged 40 years and over who had a first-time heart attack from 2004 to 2017, were treated with a coronary stent and took aspirin as prescribed during the first year after their heart attack.
Adherence to taking aspirin progressively declined, from 90% at two years following the heart attack to 84% at four years, 82% at six years and 81% at eight years.
Compared with patients who consistently took aspirin, non-adherent patients had a 29%, 40%, 31% and 20% higher likelihood of recurrent heart attack, stroke or death at two, four, six and eight years following the heart attack, respectively.
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