Chest Pain Symptoms Differences between Diabetes Mellitus and Non-Diabetes Mellitus Patients with Acute Coronary Syndrome: A Pilot Study

Manistamara, Halidah; Sella, Yurike Olivia; Apriliawan, Sony; Lukitasari, Mifetika; Rohman, Mohammad Saifur

doi:10.4081/jphr.2021.2186

Cited by 4 publications

(3 citation statements)

References 21 publications

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“…Further analyses revealed, that the observed associations did not apply to younger AMI patients (age 54 and younger) with no significant associations between diabetes and specific symptoms at all. Also prior studies have reported that diabetes goes along with less AMI symptoms including typical chest pain as well (5)(6)(7)(8)(9)(10). A current review/meta-analysis specifically analyzing chest pain symptoms and diabetes came to the same conclusion (17).…”

Section: Discussionmentioning

confidence: 52%

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Do patients with diabetes with new onset acute myocardial infarction present with different symptoms than non-diabetic patients?

Schmitz,

Wein,

Raake

et al. 2024

Front. Cardiovasc. Med.

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BackgroundThe objective of this study was to investigate the differences in presenting symptoms between patients with and without diabetes being diagnosed with an acute myocardial infarction (AMI).MethodsA total of 5,900 patients with a first-time AMI were included into the analysis. All patients aged between 25 and 84 years were recorded by the population-based Myocardial Infarction Registry in Augsburg, Germany, between 2010 and 2017. The presence (yes/no) of 12 AMI typical symptoms during the acute event was assessed within the scope of a face-to-face interview. Multivariable adjusted logistic regression models were calculated to analyze the associations between presenting symptoms and diabetes mellitus in AMI patients.ResultsPatients with diabetes had significantly less frequent typical pain symptoms, including typical chest pain. Also, other symptoms like sweating, vomiting/nausea, dizziness/vertigo and fear of death/feeling of annihilation occurred significantly more likely in non-diabetic patients. The only exception was the symptom of shortness of breath, which was found significantly more often in patients with diabetes. In multivariable-adjusted regression models, however, the observed effects were attenuated. In patients younger than 55 years, the associations between diabetes and various symptoms were mainly missing.ConclusionsType 2 diabetes mellitus is a risk factor not only for the development of AMI, but is also associated with an adverse outcome after AMI. Atypical clinical presentation additionally complicates the diagnostic process. It is therefore essential for physicians to be aware of the more often atypical symptoms that diabetic AMI patients report.

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Section: Discussionmentioning

confidence: 52%

“…Therefore, early diagnosis and timely treatment of diabetes are especially important. Prior studies indicated that AMI patients with diabetes less often report typical chest pain symptoms and some other typical AMI symptoms (5)(6)(7)(8)(9)(10). Thus, diagnostics of AMI in diabetic patients would be impeded.…”

Section: Introductionmentioning

confidence: 99%

Do patients with diabetes with new onset acute myocardial infarction present with different symptoms than non-diabetic patients?

Schmitz,

Wein,

Raake

et al. 2024

Front. Cardiovasc. Med.

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show abstract

“…Regarding patients with diabetes mellitus suffering from AMI, Manistamara et al 27 reported that these patients tend to rate their pain as less intense compared with non-diabetic patients. In contrast, we found that patients with diabetes mellitus in general rate their chest pain as higher, regardless of AMI occurrence.…”

Section: Discussionmentioning

confidence: 99%

Clinical presentation in EMS patients with acute chest pain in relation to sex, age and medical history: prospective cohort study

et al. 2022

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ObjectiveTo assess symptom presentation related to age, sex and previous medical history in patients with chest pain.DesignProspective observational cohort study.SettingTwo-centre study in a Swedish county emergency medical service (EMS) organisation.ParticipantsUnselected inclusion of 2917 patients with chest pain cared for by the EMS during 2018.Data analysisMultivariate analysis on the association between symptom characteristics, patients’ sex, age, previous acute coronary syndrome (ACS) or diabetes and the final outcome of acute myocardial infarction (AMI).ResultsSymptomology in patients assessed by the EMS due to acute chest pain varied with sex and age and also with previous ACS or diabetes. Women suffered more often from nausea (OR 1.6) and pain in throat (OR 2.1) or back (OR 2.1). Their pain was more often affected by palpation (1.7) or movement (OR 1.4). Older patients more often described pain onset while sleeping (OR 1.5) and that the onset of symptoms was slow, over hours rather than minutes (OR 1.4). They were less likely to report pain in other parts of their body than their chest (OR 1.4). They were to a lesser extent clammy (OR 0.6) or nauseous (OR 0.6). These differences were present regardless of whether the symptoms were caused by AMI or not.ConclusionsA number of aspects of the symptom of chest pain appear to differ in unselected prehospital patients with chest pain in relation to age, sex and medical history, regardless of whether the chest pain was caused by a myocardial infarction or not. This complicates the possibility in prehospital care of using symptoms to predict the underlying aetiology of acute chest pain.

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Association of chronic pain with incidence and progression of cardiometabolic multimorbidity in middle-aged and older populations: a multicohort study

You,

Zhou,

Chen

et al. 2024

PR9

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Introduction: Chronic pain is associated with single cardiometabolic diseases (CMDs). Less is known about the association of chronic pain with the co-occurrence of multiple CMDs, known as cardiometabolic multimorbidity (CMM). Objectives: This study aims to examine the association between chronic pain and incidence of CMM and if it existed, to what extent chronic pain relates to the progression of specific CMD-related multimorbidity (MM). Methods: We pooled individual-level data of 59,134 participants from 4 cohort studies across 18 countries between 2010 and 2020. Participants aged 45 years or older, free of CMDs (diabetes, heart diseases, and stroke), and with self-reported chronic pain status at baseline were included. Multinomial logistic regression was performed on the association of chronic pain with incident CMM and the progression of specific CMD-related MM. Results: One-third (21,204) of participants reported chronic pain at baseline. After 8 to 9 years, 1344 (2.3%) developed CMM. Chronic pain was associated with the onset of each CMD (odds ratio [OR] range 1.12–1.37) and CMM combinations (OR range 1.57–2.09). It is also linked with the increased odds of more CMDs (1, 2, and 3) during the follow-up. For example, OR increased from 1.31 for individuals with one CMD, to 1.57 for those with 2 CMDs, to 2.09 for those with 3 CMDs. Chronic pain was also associated with developing all CMD-related MM (OR range 1.26–1.88). Compared with those with diabetes only, participants with chronic pain were more likely to progress to diabetes and heart diseases, as well as diabetes, heart diseases, and stroke. Conclusion: Chronic pain is associated with incidence and progression of CMM, whose management should be considered in primary and secondary prevention of CMM among middle-aged and older populations.

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Chest Pain Symptoms Differences between Diabetes Mellitus and Non-Diabetes Mellitus Patients with Acute Coronary Syndrome: A Pilot Study

Cited by 4 publications

References 21 publications

Do patients with diabetes with new onset acute myocardial infarction present with different symptoms than non-diabetic patients?

Do patients with diabetes with new onset acute myocardial infarction present with different symptoms than non-diabetic patients?

Clinical presentation in EMS patients with acute chest pain in relation to sex, age and medical history: prospective cohort study

Association of chronic pain with incidence and progression of cardiometabolic multimorbidity in middle-aged and older populations: a multicohort study

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