Logo

American Heart Association

  2
  0


Final ID: MDP1715

Increased Mortality Risk in Masquerading STEMI Presentations Compared with True STEMI Patients

Abstract Body (Do not enter title and authors here): Background:
Prehospital identification of STEMI reduces time to reperfusion by timely primary PCI or fibrinolytic therapy. We previously reported that 40-50% of prehospital ECG transmissions were so-called ‘masquerading STEMI’ defined as ECGs meeting Glasgow algorithm (GA) criteria for STEMI but not meeting STEMI criteria on adjudication using the 4th Universal Definition of MI (4UDMI). We set out to determine late mortality of patients with these presentations.

Methods:
From June 2010 to October 2021, 2,992 patients at Liverpool Hospital in Sydney met GA criteria for STEMI via prehospital ECG and were classified as confirmed or masquerading STEMI per 4UDMI. Mortality risk between the two groups was compared using a Kaplan-Meier plot and further assessed using the Cox regression model, which was also used to further assess the mortality predictive value of patient baseline characteristics in the masquerading group.

Results
Patients presenting with masquerading STEMI had a hazard ratio (HR) of 2.28 (CI=1.79-2.91, p<0.001) compared with true STEMI for all-cause mortality (figure). Amongst patient characteristics in the masquerading STEMI group, age (HR=1.06[1.05-1.07]), history of stroke (HR=1.42[1.00-2.04]), CKD (HR=1.97[1.47-2.64]) and diabetes (HR=1.49[1.13-1.95]) were positively correlated with increased mortality risk while dyslipidaemia was associated with a lower risk (HR=0.64[0.48-0.86]), potentially confounded by unmeasured statin-therapy.

Conclusions
Patients presenting with masquerading STEMI have a higher risk of mortality compared to true STEMI patients, highlighting need to better charcterise these patients, and develop therapies and/or interventions that may improve outcomes.
  • Fathieh, Sina  ( Kolling Institute , Pymble , New South Wales , Australia )
  • French, John  ( LIVERPOOL HOSPITAL , Sydney , New South Wales , Australia )
  • Tran, Tu Hao  ( LIVERPOOL HOSPITAL , Sydney , New South Wales , Australia )
  • Faour, Amir  ( Medcare Hospital , Dubai , United Arab Emirates )
  • Dang, Viet  ( LIVERPOOL HOSPITAL , Sydney , New South Wales , Australia )
  • Pahn, Reece  ( LIVERPOOL HOSPITAL , Sydney , New South Wales , Australia )
  • Long, Mitchell  ( UNSW , Sydney , New South Wales , Australia )
  • Tam, Gladys  ( UNSW , Sydney , New South Wales , Australia )
  • Juergens, Craig  ( , Liverpool , New South Wales , Australia )
  • Xu, James  ( LIVERPOOL HOSPITAL , Sydney , New South Wales , Australia )
  • Author Disclosures:
    Sina Fathieh: DO NOT have relevant financial relationships | John French: DO NOT have relevant financial relationships | Tu Hao Tran: DO NOT have relevant financial relationships | Amir Faour: DO NOT have relevant financial relationships | Viet Dang: No Answer | Reece Pahn: No Answer | Mitchell Long: No Answer | Gladys Tam: DO NOT have relevant financial relationships | Craig Juergens: DO NOT have relevant financial relationships | James Xu: No Answer
Meeting Info:

Scientific Sessions 2024

2024

Chicago, Illinois

Session Info:

Prevention of Injury and Improvement in Outcomes in the ACS Population

Monday, 11/18/2024 , 12:50PM - 02:15PM

Moderated Digital Poster Session

More abstracts on this topic:
A novel reproducible low-cost model of acute myocardial infarction in swine

Li Yichen, Zheng Zilong, Tang Weijie, Chen Wangping, Yang Jinfu, Fan Chengming

Acute Ischemic Stroke Patient Factors Associated with Poor Outcomes in Patients with Favorable Collaterals and Successful Thrombectomy

Kesten Jamie, Mlynash Michael, Yuen Nicole, Seners Pierre, Wouters Anke, Schwartz Maya, Lansberg Maarten, Albers Gregory, Heit Jeremy

More abstracts from these authors:
Prognostic Characteristics of Patients with Electrocardiograms Masquerading as ST Elevation Myocardial Infarction

Fathieh Sina, Pahn Reece, Rajaratnam Rohan, Lo Sidney, Juergens Craig, Tam Gladys, French John, Tran Tu Hao, Faour Amir, Dang Viet, Aljazaery Asala, Gibbs Oliver, Assad Joseph, Faddy Steven, Long Mitchell

Acute Exposure to High PM2.5 Levels Increases the Risk of Late All-Cause Mortality in Patients with STEMI

Fathieh Sina, Tran Hao, Faour Amir, Pahn Reece, Long Mitchell, Tam Gladys, Figtree Gemma, Negishi Kazuaki, French John

You have to be authorized to contact abstract author. Please, Login
Not Available