Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC

<b>Background/Objectives</b>: Self-recognition of recurrent myocardial infarction (re-MI) may be essential for reducing prehospital time contrast to awareness of re-MI symptoms. However, data on the current status and clinical impact of self-recognition of re-MI are limited in the contemporary period. Thus, this study aimed to increase this body of knowledge. <b>Methods</b>: We enrolled 1018 patients with re-MI using data from the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centres. The patients were classified into self-recognised MI and unrecognised MI groups, and the differences between them were compared. <b>Results</b>: The rate of self-recognition among the patients with previous experience of MI was only 52.4%. Among the patients with re-MI, factors associated with self-recognition included recent first MI within 3 years, prior dyslipidaemia, two or more MI symptoms, and the male gender (<i>p</i> < 0.05). Factors associated with a lack of recognition were older age (≥70 years), prior stroke, and cancer history (<i>p</i> < 0.05). The proportion of symptoms-to-emergency room arrival time within 90 min among the patients with ST-elevation MI was significantly higher in the self-recognised group than in the unrecognised group (52.6% vs. 31.6%, <i>p</i> < 0.001). The self-recognised group showed a lower in-hospital mortality rate (1.5% vs. 6.2%, <i>p</i> < 0.001), and this benefit was maintained even after 1 year (hazard ratio: 0.53; <i>p</i> < 0.001). <b>Conclusions</b>: Only half of the patients who previously experienced a MI recognised a re-MI when it occurred. This recognition reduced prehospital delay and led to higher survival rates, which highlights the importance of patient education as well as objective monitoring devices, irrespective of individual recognition ability for immediate response.

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Journal
Journal of Clinical Medicine
Published
2024-08-16
DOI
https://doi.org/10.3390/jcm13164840
Primary Topic
Cardiac Imaging and Diagnostics
Type
article
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article

Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC

Seung Jin Lee, Jang Hoon Lee, Chang-Ok Seo, Jin‐Sin Koh et al.
Journal of Clinical Medicine
Cardiac Imaging and Diagnostics
article

Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC

Seung Jin Lee, Jang Hoon Lee, Chang-Ok Seo, Jin‐Sin Koh, Moojun Kim, Hye Ree Kim, Jae-Geun Lee, Sang Jae Rhee, Jin‐Yong Hwang, Pil Sang Song, Dong Ryeol Ryu, Kyehwan Kim, Min Gyu Kang, Hangyul Kim, Jeong Rang Park, Moo Hyun Kim, Rock Bum Kim, Shin‐Jae Kim, Sang‐Don Park, Young Joon Hong, Youn Tae-Jin, Sang Min Kim, Dae Woo Hyun
article en

Abstract

<b>Background/Objectives</b>: Self-recognition of recurrent myocardial infarction (re-MI) may be essential for reducing prehospital time contrast to awareness of re-MI symptoms. However, data on the current status and clinical impact of self-recognition of re-MI are limited in the contemporary period. Thus, this study aimed to increase this body of knowledge. <b>Methods</b>: We enrolled 1018 patients with re-MI using data from the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centres. The patients were classified into self-recognised MI and unrecognised MI groups, and the differences between them were compared. <b>Results</b>: The rate of self-recognition among the patients with previous experience of MI was only 52.4%. Among the patients with re-MI, factors associated with self-recognition included recent first MI within 3 years, prior dyslipidaemia, two or more MI symptoms, and the male gender (<i>p</i> < 0.05). Factors associated with a lack of recognition were older age (≥70 years), prior stroke, and cancer history (<i>p</i> < 0.05). The proportion of symptoms-to-emergency room arrival time within 90 min among the patients with ST-elevation MI was significantly higher in the self-recognised group than in the unrecognised group (52.6% vs. 31.6%, <i>p</i> < 0.001). The self-recognised group showed a lower in-hospital mortality rate (1.5% vs. 6.2%, <i>p</i> < 0.001), and this benefit was maintained even after 1 year (hazard ratio: 0.53; <i>p</i> < 0.001). <b>Conclusions</b>: Only half of the patients who previously experienced a MI recognised a re-MI when it occurred. This recognition reduced prehospital delay and led to higher survival rates, which highlights the importance of patient education as well as objective monitoring devices, irrespective of individual recognition ability for immediate response.

Journal of Clinical MedicineVol. 13(16)
Chonnam National University (KR), Ulsan College (KR), Kangwon National University (KR), Soonchunhyang University (KR), Dong-A University Hospital (KR), Kyungpook National University Hospital (KR), Seoul National University Bundang Hospital (KR), University of Ulsan (KR), Gyeongsang National University Hospital (KR), Chonnam National University Hospital (KR), Ulsan University Hospital (KR), Chungnam National University Hospital (KR), Inha University Hospital (KR), Chungbuk National University Hospital (KR), Jeju National University Hospital (KR), Wonkwang University (KR), Jeju National University (KR)
Seoul National University Bundang Hospital, Seoul National University, Gyeongsang National University
Good health and well-being
Openalex Percentile: Top 78%
Cardiac Imaging and Diagnostics
DOIOpen Access PDFOpenAlex
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