ArticleBMC emergency medicine2025
Impact of atypical presenting symptoms on door-to-balloon time and mortality outcomes in ST-segment elevation myocardial infarction.
Article in BMC emergency medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.
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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.
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Who cites it
2 citing papers in PubMed.
- Pre-Hospital Delay in STEMI: A Narrative Review of Symptom Onset-to-First Medical Contact Across High-Income and Low- and Middle-Income Countries.Clinical cardiology · 2026Review
- Impact of a Prehospital Chest Pain Alert App-Mediated Prehospital-in-Hospital Coordination Model on Treatment Delays and Clinical Outcomes in Patients With ST-Elevation Myocardial Infarction: Protocol for a 4-Year Retrospective Real-World Cohort Study.JMIR research protocols · 2026Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundThe impact of atypical symptom presentation in ST-segment elevation myocardial infarction (STEMI) on treatment timeliness and long-term outcomes remains insufficiently characterized. This study aimed to examine the association between symptom presentation and delays in door-to-balloon (DTB) time components and short- and long-term mortality, and to identify triage characteristics independently associated with atypical STEMI presentation.
methodsWe conducted a retrospective cohort study of STEMI patients undergoing primary percutaneous coronary intervention at a tertiary hospital in Taiwan between 2013 and 2022. Symptom presentation was classified as typical or atypical based on emergency department triage records. Primary outcomes included delays in DTB components and all-cause mortality at 30 days, 1 year, and 3 years. The secondary outcome was identification of triage characteristics associated with atypical presentation. Multivariable Cox and logistic regression models were used.
resultsOf 807 patients, 13.5% presented with atypical symptoms. Atypical presentation was independently associated with higher 30-day (aHR: 2.20, 95% CI: 1.15-4.21), 1-year (aHR: 1.91, 95% CI: 1.09-3.37), and 3-year (aHR: 1.73, 95% CI: 1.04-2.87) mortality. It was also linked to delays in door-to-ECG (aOR: 11.52, 95% CI: 6.04-22.06), activation-to-Cath lab-arrival (aOR: 1.71, 95% CI: 1.04-2.80), and Cath lab-arrival-to-balloon time (aOR: 1.95, 95% CI: 1.24-3.06). Older age, female sex, diabetes, cerebrovascular disease, tachycardia, and hypotension were independently associated with atypical presentation.
conclusionsAtypical STEMI presentation is associated with treatment delays and increased short- and long-term mortality. Early identification of high-risk patients may improve timely care and clinical outcomes. CLINICAL TRIAL NUMBER: Not applicable.
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