Patients with acute coronary syndrome frequently presented with atypical symptoms, with weakness reported in 58.7% of cases compared to classic chest pain in only 28.3%.
In a large Russian registry of ACS patients, atypical presentation without chest pain was common, and STEMI was associated with significantly higher rates of acute heart failure, cardiogenic shock, and death.
Absolute Event Rate: 0% vs 0%
Objective. To analyze clinical characteristics of patients with acute coronary syndrome according to the regional vascular center registry and to compare these results with other registries. Material and methods. The ACS register included all patients hospitalized in the regional vascular center of the Alexandrovskaya Hospital with ACS or myocardial infarction (MI). We analyzed 14412 cases of hospitalization for the period from 06.02.2016 to 22.11.2024, including 12.869 people with correctly completed data. Men comprised 58.5%. Results. Among all patients, 78.3% were admitted on the referral of emergency medical care, 12.6% — on the referral of the polyclinic, 6.8% came by self-referral, 2.3% were transferred from other hospitals; 97.7% of patients with ACS were hospitalized directly in the regional vascular center. Symptoms of ACS included weakness in 58.7% of patients, chest pain in 28.3%, shortness of breath in 9.1%; 7.8% were asymptomatic. Patients with ACS received adequate drug therapy in accordance with current clinical guidelines; the incidence of percutaneous coronary interventions was higher than mean value for the Russian Federation. Acute heart failure (p<0.0001), cardiogenic shock (p<0.0001), and death were more common in patients with ST-segment elevation. Conclusion. Hospitalization of 97.7% of patients with ACS directly in the regional vascular center indicates optimal organization of medical care for these patients. Emergency care for patients with ACS is carried out at a high level. MI may be atypical without pain syndrome that should be taken into account when making a diagnosis. More severe status of patients with STEMI dictates the need for early perfusion therapy.
Bogomolov et al. (Thu,) reported a other. Patients with acute coronary syndrome frequently presented with atypical symptoms, with weakness reported in 58.7% of cases compared to classic chest pain in only 28.3%.