Does diabetes mellitus make a difference in symptom presentation of patients with acute myocardial infarction?

Abstract

<p>Session presented on Friday, July 25, 2014:</p> <p><strong>Purpose:</strong> The study aimed to compare the differences in symptom presentation between diabetic and non-diabetic patients with acute myocardial infarction (AMI), and to examine the impact of diabetes on symptom presentation in AMI patients.</p> <p><strong>Methods:</strong> A consecutive sample of patients with a confirmed diagnosis of AMI was recruited from the cardiac units of three regional hospitals in Hong Kong. Data collection was conducted through face-to-face interview. The validated Chinese version of the Symptoms of Acute Coronary Syndromes Inventory (SACSI-C) was used for symptom assessment.</p> <p><strong>Results:</strong> A total sample of 397 patients was recruited, with the mean age of 63.3 - 12.7 years. Diabetes (32%) was the second most prevalent comorbidity in the sample. Diabetic patients were less likely to present with chest pain (p&lt;0.0001) and sweating (p=0.001). Conversely, they were more likely to present with shortness of breath (p=0.001) and difficulty in breathing (p=0.003) than the non-diabetic patients. Overall, the diabetic patients were more likely to present with atypical AMI symptoms (p&lt;0.0001). The result of multivariable logistic regression analysis showed that diabetes was an independent predictor of atypical symptom presentation in AMI patients, with an odds ratio of 2.37 (95% confidence interval: 1.36-4.12; p=0.002).</p> <p><strong>Conclusion:</strong> In summary, diabetic patients have a 2.4-fold increased risk for atypical symptom presentation than that of non-diabetic patients. Health professionals should remain vigilant at recognizing atypical AMI presentation in diabetic patients. A tailor-made educative intervention should be directed to them.</p>