PMID- 30828600
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220408
IS  - 2352-9067 (Print)
IS  - 2352-9067 (Electronic)
IS  - 2352-9067 (Linking)
VI  - 22
DP  - 2019 Mar
TI  - Very late presentation in ST elevation myocardial infarction: Predictors and 
      long-term mortality.
PG  - 156-159
LID - 10.1016/j.ijcha.2019.02.002 [doi]
AB  - BACKGROUND: Despite improvements in ST elevation myocardial infarction (STEMI) 
      care, total ischemic time remains long in patients who present late. Our goal was 
      to identify predictors of very late presentation (>/=12 h) of STEMI and determine 
      long-term mortality. METHODS: We retrospectively examined consecutive patients 
      admitted with STEMI to our institution using the ACTION Registry. Time of 
      symptom onset to first medical contact (FMC) was calculated and categorized as 
      <12 h or >/=12 h. Predictors of very late presentation were determined. RESULTS: 
      Compared to patients who presented <12 h (n = 365), those who presented >/=12 h 
      (n = 49) after symptom onset were more likely women, diabetics, and those with 
      prior coronary revascularization. In addition, patients who presented >/=12 h had 
      worse ventricular function, were less likely to report chest pain, and were less 
      likely to be transported by ambulance and to undergo coronary angiography. Late 
      presenters had higher rates of heart failure, longer hospitalizations, and were 
      less likely to be discharged home. Diabetes, female sex, and absence of chest 
      pain were strong predictors of late presentation. Long-term survival was 
      significantly lower in late presenters (73% vs. 93%, p = 0.007). CONCLUSIONS: 
      Female sex, diabetes, and absence of chest pain are strong predictors of 
      presentation delay, and long-term mortality is significantly increased in those 
      presenting very late.
FAU - McNair, Patrick W
AU  - McNair PW
AD  - Department of Medicine, Division of Cardiology, University of Virginia, 
      Charlottesville, VA, United States of America.
FAU - Bilchick, Kenneth C
AU  - Bilchick KC
AD  - Department of Medicine, Division of Cardiology, University of Virginia, 
      Charlottesville, VA, United States of America.
FAU - Keeley, Ellen C
AU  - Keeley EC
AD  - Department of Medicine, Division of Cardiovascular Medicine, University of 
      Florida, Gainesville, FL, United States of America.
LA  - eng
PT  - Journal Article
DEP - 20190220
PL  - Ireland
TA  - Int J Cardiol Heart Vasc
JT  - International journal of cardiology. Heart & vasculature
JID - 101649525
PMC - PMC6383163
OTO - NOTNLM
OT  - Late presentation
OT  - STEMI
EDAT- 2019/03/05 06:00
MHDA- 2019/03/05 06:01
PMCR- 2019/02/20
CRDT- 2019/03/05 06:00
PHST- 2018/12/11 00:00 [received]
PHST- 2019/02/03 00:00 [accepted]
PHST- 2019/03/05 06:00 [entrez]
PHST- 2019/03/05 06:00 [pubmed]
PHST- 2019/03/05 06:01 [medline]
PHST- 2019/02/20 00:00 [pmc-release]
AID - S2352-9067(19)30004-1 [pii]
AID - 10.1016/j.ijcha.2019.02.002 [doi]
PST - epublish
SO  - Int J Cardiol Heart Vasc. 2019 Feb 20;22:156-159. doi: 
      10.1016/j.ijcha.2019.02.002. eCollection 2019 Mar.