Kim Kyehwan, Kim Moojun, Seo Chang-Ok, Kim Hangyul, Kim Hye Ree, Kang Min Gyu, Koh Jin-Sin, Park Jeong Rang, Kim Rock Bum, Ryu Dong Ryeol, Lee Jang Hoon, Kim Moo Hyun, Youn Tae-Jin, Hyun Dae Woo, Kim Shin-Jae, Rhee Sang Jae, Park Sang-Don, Hong Young Joon, Lee Jae-Geun, Song Pil Sang, Kim Sang Min, Lee Seung Jin, Hwang Jin-Yong
Division of Cardiology, Department of Internal Medicine, Gyeongsang National University School of Medicine, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea.
Regional Cardiocerebrovascular Disease Center, Gyeongsang National University Hospital, Jinju 52727, Republic of Korea.
J Clin Med. 2024 Aug 16;13(16):4840. doi: 10.3390/jcm13164840.
: Self-recognition of recurrent myocardial infarction (re-MI) may be essential for reducing prehospital time contrast to awareness of re-MI symptoms. However, data on the current status and clinical impact of self-recognition of re-MI are limited in the contemporary period. Thus, this study aimed to increase this body of knowledge. : We enrolled 1018 patients with re-MI using data from the Korean Registry of Acute Myocardial Infarction for Regional Cardiocerebrovascular Centres. The patients were classified into self-recognised MI and unrecognised MI groups, and the differences between them were compared. : The rate of self-recognition among the patients with previous experience of MI was only 52.4%. Among the patients with re-MI, factors associated with self-recognition included recent first MI within 3 years, prior dyslipidaemia, two or more MI symptoms, and the male gender ( < 0.05). Factors associated with a lack of recognition were older age (≥70 years), prior stroke, and cancer history ( < 0.05). The proportion of symptoms-to-emergency room arrival time within 90 min among the patients with ST-elevation MI was significantly higher in the self-recognised group than in the unrecognised group (52.6% vs. 31.6%, < 0.001). The self-recognised group showed a lower in-hospital mortality rate (1.5% vs. 6.2%, < 0.001), and this benefit was maintained even after 1 year (hazard ratio: 0.53; < 0.001). : Only half of the patients who previously experienced a MI recognised a re-MI when it occurred. This recognition reduced prehospital delay and led to higher survival rates, which highlights the importance of patient education as well as objective monitoring devices, irrespective of individual recognition ability for immediate response.
与对再发性心肌梗死（re-MI）症状的认知相比，自我识别再发性心肌梗死对于缩短院前时间可能至关重要。然而，在当代，关于再发性心肌梗死自我识别的现状和临床影响的数据有限。因此，本研究旨在增加这方面的知识。
我们使用韩国区域心脑血管中心急性心肌梗死登记处的数据，纳入了1018例再发性心肌梗死患者。将患者分为自我识别心肌梗死组和未识别心肌梗死组，并比较两组之间的差异。
既往有心肌梗死病史的患者中，自我识别率仅为52.4%。在再发性心肌梗死患者中，与自我识别相关的因素包括3年内近期首次心肌梗死、既往血脂异常、两种或更多心肌梗死症状以及男性（<0.05）。与未识别相关的因素包括年龄较大（≥70岁）、既往中风和癌症病史（<0.05）。ST段抬高型心肌梗死患者中，自我识别组症状至急诊室就诊时间在90分钟内的比例显著高于未识别组（52.6%对31.6%，<0.001）。自我识别组的院内死亡率较低（1.5%对6.2%，<0.001），即使在1年后这种益处仍得以维持（风险比：0.53；<0.001）。
既往有心肌梗死病史的患者中，只有一半在再发性心肌梗死发生时能够自我识别。这种识别减少了院前延误并提高了生存率，这凸显了患者教育以及客观监测设备的重要性，无论个体的即时反应识别能力如何。
