Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis

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Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis. / Lindahl, B.; Ljung, L.; Herlitz, J.; Alfredsson, J.; Erlinge, D.; Kellerth, T.; Omerovic, E.; Ravn-Fischer, A.; Sparv, D.; Yndigegn, T.; Svensson, P.; Östlund, O.; Jernberg, T.; James, S. K.; Hofmann, R.; DETO2X-SWEDEHEART Investigators.

In: Journal of Internal Medicine, 2021.

Research output: Contribution to journalArticle

Harvard

Lindahl, B, Ljung, L, Herlitz, J, Alfredsson, J, Erlinge, D, Kellerth, T, Omerovic, E, Ravn-Fischer, A, Sparv, D, Yndigegn, T, Svensson, P, Östlund, O, Jernberg, T, James, SK, Hofmann, R & DETO2X-SWEDEHEART Investigators 2021, 'Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis', Journal of Internal Medicine. https://doi.org/10.1111/joim.13272

APA

Lindahl, B., Ljung, L., Herlitz, J., Alfredsson, J., Erlinge, D., Kellerth, T., Omerovic, E., Ravn-Fischer, A., Sparv, D., Yndigegn, T., Svensson, P., Östlund, O., Jernberg, T., James, S. K., Hofmann, R., & DETO2X-SWEDEHEART Investigators (2021). Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis. Journal of Internal Medicine. https://doi.org/10.1111/joim.13272

CBE

Lindahl B, Ljung L, Herlitz J, Alfredsson J, Erlinge D, Kellerth T, Omerovic E, Ravn-Fischer A, Sparv D, Yndigegn T, Svensson P, Östlund O, Jernberg T, James SK, Hofmann R, DETO2X-SWEDEHEART Investigators. 2021. Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis. Journal of Internal Medicine. https://doi.org/10.1111/joim.13272

MLA

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Author

Lindahl, B. ; Ljung, L. ; Herlitz, J. ; Alfredsson, J. ; Erlinge, D. ; Kellerth, T. ; Omerovic, E. ; Ravn-Fischer, A. ; Sparv, D. ; Yndigegn, T. ; Svensson, P. ; Östlund, O. ; Jernberg, T. ; James, S. K. ; Hofmann, R. ; DETO2X-SWEDEHEART Investigators. / Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis. In: Journal of Internal Medicine. 2021.

RIS

TY - JOUR

T1 - Poor long-term prognosis in patients admitted with strong suspicion of acute myocardial infarction but discharged with another diagnosis

AU - Lindahl, B.

AU - Ljung, L.

AU - Herlitz, J.

AU - Alfredsson, J.

AU - Erlinge, D.

AU - Kellerth, T.

AU - Omerovic, E.

AU - Ravn-Fischer, A.

AU - Sparv, D.

AU - Yndigegn, T.

AU - Svensson, P.

AU - Östlund, O.

AU - Jernberg, T.

AU - James, S. K.

AU - Hofmann, R.

AU - DETO2X-SWEDEHEART Investigators

PY - 2021

Y1 - 2021

N2 - Background: Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives: To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis. Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1–3.7 years) irrespective of randomized treatment. Results: 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF. Conclusions: Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis.

AB - Background: Characteristics and prognosis of patients admitted with strong suspicion of myocardial infarction (MI) but discharged without an MI diagnosis are not well-described. Objectives: To compare background characteristics and cardiovascular outcomes in patients discharged with or without MI diagnosis. Methods: The DETermination of the role of Oxygen in suspected Acute Myocardial Infarction (DETO2X-AMI) trial compared 6629 patients with strong suspicion of MI randomized to oxygen or ambient air. The main composite end-point of this subgroup analysis was the incidence of all-cause death, rehospitalization with MI, heart failure (HF) or stroke during a follow-up of 2.1 years (median; range: 1–3.7 years) irrespective of randomized treatment. Results: 1619 (24%) received a non-MI discharge diagnosis, and 5010 patients (76%) were diagnosed with MI. Groups were similar in age, but non-MI patients were more commonly female and had more comorbidities. At thirty days, the incidence of the composite end-point was 2.8% (45 of 1619) in non-MI patients, compared to 5.0% (250 of 5010) in MI patients with lower incidences in all individual end-points. However, for the long-term follow-up, the incidence of the composite end-point increased in the non-MI patients to 17.7% (286 of 1619) as compared to 16.0% (804 of 5010) in MI patients, mainly driven by a higher incidence of all-cause death, stroke and HF. Conclusions: Patients admitted with a strong suspicion of MI but discharged with another diagnosis had more favourable outcomes in the short-term perspective, but from one year onwards, cardiovascular outcomes and death deteriorated to a worse long-term prognosis.

KW - acute myocardial infarction

KW - cardiovascular clinical research

KW - cardiovascular risk factors

KW - chest pain

KW - noncardiac chest pain

KW - randomized clinical trial

U2 - 10.1111/joim.13272

DO - 10.1111/joim.13272

M3 - Article

C2 - 33576075

AN - SCOPUS:85102508461

JO - Journal of Internal Medicine

JF - Journal of Internal Medicine

SN - 1365-2796

ER -