Noncardiac chest pain after acute myocardial infarction: Frequency and association with health status outcomes

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Abstract

Background

The frequency of noncardiac chest pain (CP) hospitalization after acute myocardial infarction (AMI) is unknown, and its significance from patients’ perspectives is not studied.

Objectives

To assess the frequency of noncardiac CP admissions after AMI and its association with patients’ self-reported health status.

Methods

We identified cardiac and noncardiac CP hospitalizations in the year after AMI from the 24-center TRIUMPH registry. Hierarchical repeated-measures regression was used to identify the association of these hospitalizations with patients’ self-reported health status using the Seattle Angina Questionnaire Quality of Life domain (SAQ QoL) and Short Form 12 (SF-12) physical (PCS) and mental (MCS) component summary scores.

Results

Of 3,099 patients, 318 (10.3%) were hospitalized with CP, of whom 92 (28.9%) were hospitalized for noncardiac CP. Compared with patients not hospitalized with CP, noncardiac CP hospitalization was associated with poorer health status (SAQ QoL–adjusted differences: −8.9 points [95% CI −12.1 to −5.6]; SF-12 PCS: −2.5 points [95% CI −4.2 to −0.8] and SF-12 MCS: −3.5 points [95% CI −5.1 to −1.9]). The SAQ QoL for patients hospitalized with noncardiac CP was similar to patients hospitalized with cardiac CP (adjusted difference: 0.6 points [95% CI −3.2 to 4.5]; SF-12 PCS (0.9 points [95% CI −1.1 to 2.9]), but was worse with regard to SF-12 MCS (adjusted difference: −2.0 points [95% CI −3.9 to −0.2]).

Conclusions

Noncardiac CP accounted for a third of CP hospitalizations within 1 year of AMI and was associated with similar disease-specific QoL as well as general physical and mental health status impairment compared with cardiac CP hospitalization.

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