STEMI Symptom Presentation Delayed in Diabetes

Patients with diabetes and presented with STEMI symptoms on average 50 minutes later than those without diabetes.
Patients with diabetes and presented with STEMI symptoms on average 50 minutes later than those without diabetes.

Patients with diabetes are likely to experience delayed presentation of symptoms in ST-segment elevation myocardial infarction (STEMI) compared with those without diabetes, according to research presented at the 66th Annual Scientific Session & Expo of the American College of Cardiology in Washington, DC.

Researchers from Loma Linda University Medical Center in California conducted a retrospective study to evaluate the correlation between atypical symptoms and increased time to presentation in patients with both STEMI and diabetes vs patients with STEMI but without diabetes.

 

Data from 766 patients was collected from a tertiary care medical center between 2008 and 2015; 238 of the patients who presented with STEMI had diabetes.

On average, patients with STEMI and diabetes presented 50 minutes later than patients with STEMI but without diabetes (194.8 vs 144.8 minutes; P =.0054); the most common symptom of presentation was chest pain (87.4% vs 89.1%, respectively; P =.561).

Time to presentation grew for every unit increase in patient's hemoglobin A1c level (P =.0035). No significant difference in initial troponin level was noted between the 2 groups (2.02 ng/mL vs 2.17 ng/mL, respectively; P =.59); however, length of hospital stay was significantly longer in those with STEMI and diabetes (3.37 days vs 2.87 days, respectively; P =.011).

The researchers noted that similar chest pain presentation was in contrast to prior observations. 

Reference

Evans J, Khachatryan T, Hamilton D, et al. Glycemic control in insulin and non-insulin dependent diabetic patients with ST elevation myocardial infarction predicts time to presentation. Abstract 1126-322. Presented at: 66th Annual Scientific Session & Expo of the American College of Cardiology. March 17-19, 2017; Washington, DC. 

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