of age and sex with MI symptom presentation 年龄性别与MI症状的关联课件.pptVIP

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of age and sex with MI symptom presentation 年龄性别与MI症状的关联课件.ppt

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of age and sex with MI symptom presentation 年龄性别与MI症状的关联课件

Journal Club By Ben Selph, Mercer COPHS April 6, 2012 SEGA Geriatrics Each year more than 1.2 million people will experience an ACS event (unstable angina, heart attack). 220,000 will die of a heart attack (myocardial infarction-MI). Optimum treatment for a heart attack depends on timely recognition of symptoms and treatment of the event. Goals—for fibrinolytic treatment (medication to bust clot): within 30 minutes For stint placement (PCI): within 90 minutes. Hallmark symptom of a heart attack: CHEST PAIN/DISCOMFORT. However, a large number of patients with MI do not present with chest pain. These patients tend to present later, are treated less aggressively, and have almost twice the short-term mortality compared with those with typical symptoms. Younger women with MI may have higher mortality risk than men; lack of CP may contribute. Women are generally older than men at hospitalization for MI. May be related to whether they present with CP But studies measuring sex differences in presentation are limited in number. Goal: answer question of whether lack of chest pain was associated with higher mortality observed in younger women with MI. Purpose and objectives: examine relationship among patients hospitalized with MI between sex and symptom presentation (primary) and sex, symptom presentation, and hospital mortality rate (secondary) after accounting for age. Restrospective observational study Patient population: NRMI patient population of 2,160,671 patients admitted with confirmed MI at 1977 participating hospitals from 1994-2006. Diagnosis of acute MI: clinical presentation consistent with acute MI, determined by HC providers at each hospital. Diagnostic code 410.X1 or supporting evidence (elevated cardiac biomarker level, electrocardiographic evidence, or other enzymatic, nuclear, or autopsy evidence of acute MI). Excluded patients: transferred patients, patients with missing info on sex, age, or symptomatic presentation, and patients with secondary d