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Effect of Patient's Symptom Interpretation on In-Hospital Mortality in Acute Coronary Syndrome

Ryo Ninomiya1, Yorihiko Koeda1, Takahito Nasu1

  • 1Division of Cardiology, Department of Internal Medicine, Iwate Medical University.

Circulation Journal : Official Journal of the Japanese Circulation Society
|June 16, 2024
PubMed

Insights

Patients with acute coronary syndrome (ACS) who recognized their symptoms as heart disease had better in-hospital outcomes. Early symptom interpretation in ACS patients is crucial for improving prognosis and reducing mortality.

Area of Science:

  • Cardiology
  • Clinical Medicine
  • Public Health

Background:

  • The link between how patients interpret symptoms and their prognosis in acute coronary syndrome (ACS) is understudied.
  • Investigating heart disease awareness in ACS patients is vital for understanding in-hospital mortality.

Purpose of the Study:

  • To evaluate the impact of heart disease awareness on in-hospital mortality among patients with ACS.
  • To explore the relationship between prehospital symptom interpretation and clinical outcomes in ACS.

Main Methods:

  • A post hoc analysis of 1,979 ACS patients admitted between 2014 and 2018.
  • Compared outcomes between patients who interpreted symptoms as cardiac disease versus those who did not.
  • Analyzed patient characteristics, recanalization times (door-to-balloon, onset-to-balloon), and in-hospital mortality using Cox regression.

Main Results:

  • 1,264 patients recognized cardiac symptoms; 715 did not.
  • No significant difference in door-to-balloon time, but onset-to-balloon time was shorter for those recognizing cardiac symptoms (254 vs. 345 min; P<0.001).
  • Patients not interpreting symptoms as cardiac disease had a higher risk of in-hospital mortality (HR 1.73; P=0.022).

Conclusions:

  • Prehospital symptom interpretation is significantly associated with in-hospital clinical outcomes in ACS patients.
  • Prognostic differences appear linked to onset-to-balloon time, not door-to-balloon time.
  • Early recognition of cardiac symptoms in ACS may improve patient prognosis.
Abstract

Keywords:
Clinical prognosisOnset-to-balloon timePrehospital awarenessRisk factors

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