Factors Associated with False-positive ST-segment Elevation Myocardial Infarction Activated by Emergency Physician
Journal of the Korean Society of Emergency Medicine
;
: 36-42, 2016.
Article
in English
| WPRIM
| ID: wpr-98046
ABSTRACT
PURPOSE:
Rapid activation of the cardiac catheterization laboratory (CCL) is fundamental in the treatment of ST-segment elevation myocardial infarction (STEMI), and it is recommended that emergency department physicians activate CCL as soon as possible, however false positive activation is a major concern. The aim of this study is to assess the relationship between false positive activation and clinical factors available at the time of diagnosis.METHODS:
All subjects with CCL activation by an emergency physician between August 2009 and May 2012 were included in this study. False-positive CCL activation was defined as absence of a clear culprit lesion on coronary angiography or by assessment of electrocardiographic and biomarker data in the absence of angiography.RESULTS:
Of 222 STEMI activations by emergency physicians, 55 (25%) were false-positive STEMI. Coronary spasm, cardiomyopathy, known CAD, and heart failure were the most common diagnoses among false-positive STEMI. A history of cardiomyopathy (adjusted odds ratio, 13.393; 95% CI, 2.550-70.334; p=0.002), systolic blood pressure<100 mmHg at presentation (adjusted odds ratio, 2.817; 95% CI, 1.129-7.026; p=0.026), no chest pain on admission (adjusted odds ratio, 2.460; 95% CI, 1.162-5.209; p=0.019), and prior coronary disease (adjusted odds ratio, 3.966; 95% CI, 1.828-8.606; p<0.001) independently increased the odds of false-positive STEMI activations.CONCLUSION:
False-positive CCL activations were relatively common according to the definition in this study. Various patient-level characteristics were significantly associated with false-positive CCL activation.
Full text:
Available
Index:
WPRIM (Western Pacific)
Main subject:
Spasm
/
Chest Pain
/
Angiography
/
Cardiac Catheterization
/
Odds Ratio
/
Predictive Value of Tests
/
Coronary Angiography
/
Coronary Disease
/
Diagnosis
/
Diagnosis, Differential
Type of study:
Diagnostic study
/
Etiology study
/
Prognostic study
Language:
English
Journal:
Journal of the Korean Society of Emergency Medicine
Year:
2016
Type:
Article
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