title: Characteristics of patients with false- ST-segment elevation myocardial infarction diagnoses.
abstract: BACKGROUND
  A subgroup of patients presenting with suspected ST-elevation myocardial infarction (STEMI) have no culprit lesion during coronary angiography (false-positive STEMI). Little is known about patient- and system-related factors that are associated with false-positive STEMI. We evaluated the incidence, correlates, delay, final diagnosis, and outcome of patients with false-positive STEMI.
  
  
  METHODS
  We studied 827 consecutive patients presenting with suspected STEMI between January 2011-September 2012.
  
  
  RESULTS
  A false positive STEMI activation was identified in 68 patients (8.2%). Patients with false-positive STEMI were younger (57 vs 63 year; p=0.020), less often had hypercholesterolemia (19 vs 43%; p=0.001), and had a higher heart rate (82 vs 75 bpm; p=0.014). The association between these factors and false-positive STEMI activation persisted in multivariate analysis. The duration of symptoms to call was longer in false-positive STEMI patients (128 vs 83 min; p=0.030), although this did not reach statistical significance in multivariate analysis. Final diagnosis in patients with false-positive STEMI activation was particularly from unknown origin (41%). There were no significant differences in mortality at 30 days and one year between patients with STEMI and false-positive STEMI.
  
  
  CONCLUSIONS
  The incidence of false-positive STEMI was 8.2% in patients suspected of STEMI. Patients with false-positive STEMI differ from STEMI patients in certain baseline characteristics and in patient delay. Interestingly, absence of coronary disease did not translate into better clinical outcome.
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Hilde E
authors: HE
authors: Groot
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Wouter G
authors: WG
authors: Wieringa
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Karim D
authors: KD
authors: Mahmoud
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Chris Ph
authors: CP
authors: Lexis
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Bart
authors: B
authors: Hiemstra
authors: Department of Cardiology, University of Groningen, The Netherlands.
authors: Pim
authors: P
authors: van der Harst
authors: Department of Cardiology, University of Groningen, The Netherlands e.lipsic@umcg.nl.
authors: Erik
authors: E
authors: Lipsic
mesh_terms: D000328:Adult; D017677:Age Distribution; D000368:Aged; D017023:Coronary Angiography; D003951:Diagnostic Errors / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D012307:Risk Factors; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000473:pathology
keywords: False-positive activation; ST-segment elevation myocardial infarction; coronary angiography; percutaneous coronary intervention