Evidence map›Paper›PMID 34815999›Full record

ArticleInternational journal of cardiology. Heart & vasculature2021

Association between pre-hospital chest pain severity and myocardial injury in ST elevation myocardial infarction: A post-hoc analysis of the AVOID study.

Himawan Fernando, Ziad Nehme, Karlheinz Peter, Stephen Bernard, Michael Stephenson, Janet E Bray, Paul S Myles, Romi Stub, Peter Cameron, Andris H Ellims and 4 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
0.2field-weighted citation impact, top 45% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

14 authors at 3 institutions in 1 country.

Himawan FernandoDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
Ziad NehmeCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Karlheinz PeterDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
Stephen BernardCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Michael StephensonCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Janet E BrayCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Paul S MylesDepartment of Epidemiology and Preventive Medicine, Monash University, Melbourne, Australia.
Romi StubDepartment of Anaesthesiology and Perioperative Medicine, The Alfred and Monash University, Australia.
Peter CameronCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Andris H EllimsDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
Andrew J TaylorDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
David M KayeDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
Karen SmithCentre for Research and Evaluation, Ambulance Victoria, Melbourne, Australia.
Dion StubDepartment of Cardiology, Alfred Hospital, Melbourne, Australia.
Ambulance Victoria · AUBaker Heart and Diabetes Institute · AUThe Alfred Hospital · AU

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe sought to determine if an association exists between prehospital chest pain severity and markers of myocardial injury. METHODS AND

resultsPatients with confirmed ST elevation myocardial infarction (STEMI) treated by emergency medical services were included in this retrospective cohort analysis of the AVOID study. The primary endpoint was the association of pre-hospital initial chest pain severity, cardiac biomarkers and infarct size based on cardiac magnetic resonance imaging. Groups were categorized based on moderate to severe chest pain (numerical rating scale pain ≥ 5/10) or less than moderate severity to compare procedural and clinical outcomes. 414 patients were included in the analysis. There was a weak correlation between initial pre-hospital chest pain severity and peak creatine kinase (r = 0.16, p = 0.001) and peak cardiac troponin I (r = 0.14, p = 0.005). Both were no longer significant after adjusting for known confounders. There was no association between moderate to severe chest pain on arrival and major adverse cardiac events at 6 months (20% vs. 14%, p=0.12). There was a weak correlation between history of ischemic heart disease (r = 0.16, p = 0.001), percutaneous coronary intervention (r = 0.16, p = 0.001), left anterior descending artery (r = 0.12, p = 0.012) as the culprit vessel and a weak negative correlation between age (r = -0.14, p = 0.039) and chest pain.

conclusionOnly a weak association between pre-hospital chest pain severity and markers of myocardial injury was identified, supporting more judicious use of opioid analgesia with a focus on patient comfort.

Indexed as

Chest pain predictorsInfarct sizeMyocardial infarctionOpioid analgesiaPain severity

Identifiers

PMID34815999
PMCPMC8591354
OpenAlexW3213376303

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.