Table 4.
Patient and system delays, severity indicators, risk stratification and 30-day mortality according to clinical presentation*
| Typical (chest) pain† | Atypical or mixture pain | P value | No symptom cluster‡ | Dyspnoea and sweating cluster | Multiple symptoms cluster | P value | |
| Patient and system delays, median (IQR) | |||||||
| STEMI/NC ACS | |||||||
| Symptom onset—FMC (min) | 85 (45–210) | 135 (65–325) | 0.012 | 90 (46–240) | 90 (50–185) | 83 (45–430) | 0.872 |
| Symptom onset—arterial access (min) | 328 (192–1075) | 414 (246–1335) | 0.080 | 321 (194–1011) | 384 (201–1440) | 533 (323–1428) | 0.111 |
| NSTEACS | |||||||
| Symptom onset—FMC (min) | 130 (60–393) | 139 (60–335) | 0.633 | 135 (60–390) | 150 (60–390) | 113 (45–393) | 0.795 |
| Hospital admission—coronary angiography time (hours) | 30 (18–57) | 29 (20–48) | 0.884 | 30 (18–56) | 35 (18–70) | 28 (20–72) | 0.385 |
| Admission variables | |||||||
| Heart rate, mean (SD), bpm | 77 (18) | 80 (24) | 0.117 | 78 (19) | 77 (19) | 78 (28) | 0.923 |
| Systolic blood pressure, mean (SD), mm Hg | 144 (49) | 139 (30) | 0.212 | 145 (59) | 141 (30) | 136 (33) | 0.364 |
| Haemodynamic instability at admission§ | 32 (4.6) | 14 (9.7) | 0.014 | 41 (6.4) | 7 (4.2) | 9 (13.4) | 0.034 |
| Risk stratification | |||||||
| Calculated GRACE risk score, mean (SD) | 134 (36) | 147 (39) | <0.001 | 137 (37) | 138 (35) | 149 (44) | 0.041 |
| Calculated CRUSADE risk score, median (IQR) | 21 (11–34) | 25 (14–41) | 0.012 | 22 (12–36) | 23 (10–36) | 30 (16–47) | 0.019 |
| Moderate or severe left ventricular systolic dysfunction | 169 (24.9) | 46 (32.9) | 0.052 | 164 (26.4) | 55 (33.3) | 17 (25.4) | 0.187 |
| 30-Day mortality rate adjusted for the GRACE V.2.0 risk score, mean (SD) | 2.0 (4.0) | 1.3 (1.4) | 0.521 | 0.9 (2.0) | 0.9 (2.0) | 4.9 (5.5) | <0.001 |
*Values are number and percentage unless otherwise indicated. Total may not add to 100% due to missing data.
†Chest pain: retrosternal, precordial, right thoracic or bilateral thoracic.
‡No symptom cluster: low endorsement probabilities for all items; dyspnoea and sweating cluster: high probability for dyspnoea atrest and sweating; multiple symptoms cluster: high probabilities for all items (dyspnoea at rest, exertional dyspnoea, sweating, nausea, vomiting, dizziness, blurry vision, presyncope, syncope, palpitation, weakness, other symptoms, other digestive symptoms and discomfort).
§Killip class III or IV; or shock at admission.
CRUSADE, Can Rapid risk stratification of Unstable angina patients Suppress ADverse outcomes; FMC, first medical contact; GRACE, Global Registry of Acute Coronary Events; NSTEACS, non-ST- elevation acute coronary syndrome; STEMI/NC ACS, ST- elevation myocardial infarction/non-classifiable acute coronary syndrome.