title: Characteristics and Outcomes of MI Patients with and without Chest Pain: A Cohort Study.
abstract: BACKGROUND
  There are conflicting data on patient characteristics and outcomes of myocardial infarction (MI) patients presenting with and without the symptom of chest pain.
  
  
  OBJECTIVE
  Compare the characteristics and survival of patients stratified by the symptom chest pain.
  
  
  METHODS
  This retrospective cohort study identified patients with an emergency department discharge diagnosis of MI, who arrived by ambulance at a teaching hospital in Perth, Western Australia, between January 2008 to October 2009. The cohort was linked to hospital data and the state-based death register; clinical data were extracted by medical record review. Patient characteristics were compared using logistic regression models and survival analysis using Kaplan-Meier curves and Cox regression models.
  
  
  RESULTS
  Of 382 patients, 26% presented without chest pain. The odds of presenting without chest pain were increased if aged 80+ (OR 7.54; 95%CI 2.81-20.3) and aged 70-79 years (OR 4.33; 95% CI 1.50-12.5), and female (OR 1.67; 95%CI 0.99-2.82). The adjusted hazard (median follow-up time 2.2 years) of presenting without chest pain was not significantly associated with survival (HR 1.03; 95%CI 0.71-1.48).
  
  
  CONCLUSIONS
  Characteristics differed between patients with and without chest pain. However, the symptom of chest pain was not associated with survival.
authors: Faculty of Health, Engineering and Science, School of Nursing and Midwifery, Edith Cowan University, Perth, Australia; School of Population Health, The University of Western Australia, Perth, Australia; Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia. Electronic address: l.coventry@ecu.edu.au.
authors: Linda L
authors: LL
authors: Coventry
authors: School of Population Health, The University of Western Australia, Perth, Australia.
authors: Alexandra P
authors: AP
authors: Bremner
authors: Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia; St John Ambulance (Western Australia), Perth, Western Australia, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Australia.
authors: Teresa A
authors: TA
authors: Williams
authors: Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia.
authors: Antonio
authors: A
authors: Celenza
authors: Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia; St John Ambulance (Western Australia), Perth, Western Australia, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Australia.
authors: Ian G
authors: IG
authors: Jacobs
authors: Discipline of Emergency Medicine, School of Primary, Aboriginal and Rural Health Care, The University of Western Australia, Perth, Australia; St John Ambulance (Western Australia), Perth, Western Australia, Australia; Prehospital, Resuscitation and Emergency Care Research Unit (PRECRU), Curtin University, Perth, Australia; School of Public Health & Preventive Medicine, Monash University, Melbourne, Australia.
authors: Judith
authors: J
authors: Finn
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D002637:Chest Pain / Q000401:mortality / Q000503:physiopathology; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000401:mortality / Q000503:physiopathology; D012189:Retrospective Studies; D015996:Survival Rate
keywords: Atypical presentation; Myocardial infarction; Patient outcomes; Survival; Symptoms