Clinical Impact of Self-Recognition of Recurrent Acute Myocardial Infarction: From KRMI-RCC

TL;DR

This study finds that only about half of patients who previously had a heart attack recognize a recurrence, and those who do are more likely to seek timely care and survive.

Contribution

The study identifies factors influencing self-recognition of recurrent heart attacks and demonstrates its impact on survival rates.

Findings

Only 52.4% of patients with prior MI recognized a re-MI.

Self-recognised re-MI patients had a 52.6% vs. 31.6% rate of arriving within 90 minutes to the ER.

Self-recognised group had lower in-hospital mortality (1.5% vs. 6.2%) and better 1-year survival.

Abstract

Background/Objectives: 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. Methods: 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. Results: 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 (p < 0.05). Factors associated with a lack of recognition were older age (≥70 years), prior stroke, and cancer history (p < 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%, p < 0.001). The self-recognised group showed a lower in-hospital mortality rate (1.5% vs. 6.2%, p < 0.001), and this benefit was maintained even after 1 year (hazard ratio: 0.53; p < 0.001). Conclusions: 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.

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