Atypical presentation of XXXX : a significant independent predictor of in-hospital mortality.

@entity1 @entity1187 @entity662 @entity1353 @entity158
BACKGROUND: @entity1 with @entity1187 ( @entity1187 ) frequently present with typical @entity662 ; however a considerable proportion may present with atypical symptoms. OBJECTIVE: The purpose of this study was to evaluate the prognostic value of different presenting symptoms in @entity1187 @entity1 . METHODS: Over a 5-month period in 2007, 6704 consecutive @entity1 presenting with @entity1187 were enrolled and categorized into three groups according to their presenting symptom (typical @entity662 , atypical @entity662 , and @entity1353 ). Data were collected from a prospective, multicenter, multinational, observational study from 6 countries. The baseline characteristics, therapy, and in-hospital outcomes were analyzed and compared in the three groups. RESULTS: In comparison to typical @entity662 , @entity1 with @entity158 or @entity1353 were older and had more cardiovascular risk factors. These two groups were significantly less likely to receive evidence-based therapy and coronary angiography and suffered worse in-hospital outcomes. The mortality rates were 3%, 2.5%, and 6% in @entity1 presenting with typical, atypical @entity662 , and @entity1353 , respectively. After adjustment for confounders, the absence of typical @entity662 was associated with higher mortality rate (odds ratio 2.0, 95% confidence intervals 1.29-2.75). CONCLUSIONS: Across @entity1187 , @entity1 presenting without @entity662 were frequently underestimated, less well treated with evidence-based therapy, and had worse in-hospital outcomes. Clinical presentation of @entity1187 may provide additional prognostic impact particularly in high-risk populations.
