背景:在急性冠脉综合征(ACS)患者中,症状解释与预后之间的关系尚未得到很好的研究。因此,本研究评估了ACS患者对心脏病认知对院内死亡率的影响.方法和结果:我们对2014年至2018年间入院时确认症状解释的1,979例连续ASC患者进行了事后分析,重点关注患者特征,再通时间,和临床结果。一被录取,1,264名患者将其病情解释为心脏病,而715没有将他们的病情解释为心脏病。尽管两组之间的门至球囊时间没有显着差异。在那些将自己的病情解释为心脏病的人中,从气球开始的时间明显较短(254vs.345分钟;P<0.001)。此外,根据已确定的危险因素校正后的Cox回归模型,未将病情解释为心脏病的患者的院内死亡率风险比(HR1.73;95%置信区间1.08~2.76;P=0.022)显著更高.
结论:这项研究表明,院前症状的解释与ACS患者的院内临床结局显著相关。此外,观察到的临床预后差异与门到球囊时间无关,但可能与球囊发作时间有关。
The association between symptom interpretation and prognosis has not been investigated well among patients with acute coronary syndrome (ACS). As such, the present study evaluated the effect of heart disease awareness among patients with ACS on in-hospital mortality.
We performed a post hoc analysis of 1,979 consecutive patients with ASC with confirmed symptom interpretation on admission between 2014 and 2018, focusing on patient characteristics, recanalization time, and clinical outcomes. Upon admission, 1,264 patients interpreted their condition as cardiac disease, whereas 715 did not interpret their condition as cardiac disease. Although no significant difference was observed in door-to-balloon time between the 2 groups, onset-to-balloon time was significantly shorter among those who interpreted their condition as cardiac disease (254 vs. 345 min; P<0.001). Moreover, the hazard ratio (HR) for in-hospital mortality was significantly higher among those who did not interpret their condition as cardiac disease based on the Cox regression model adjusted for established risk factors (HR 1.73; 95% confidence interval 1.08-2.76; P=0.022).
This study demonstrated that prehospital symptom interpretation was significantly associated with in-hospital clinical outcomes among patients with ACS. Moreover, the observed differences in clinical prognosis were not related to door-to-balloon time, but may be related to onset-to-balloon time.