Positive OR (95% CI) for NSTEMI by symptoms in all patients and by sex
| N of total (%) | All (n=1506) | Men (n=909) | Women (n=597) | P value for interaction | |
| Presenting symptom | |||||
| Chest pain | 1468 (97.5) | 1.55 (0.47–5.09) | 2.05 (0.48–8.75) | 0.97 (0.12–7.76) | 0.565 |
| Location* | |||||
| Retrosternal | 661 (45.0) | 2.09 (1.51–2.89) | 2.24 (1.51–3.34) | 1.75 (0.98–3.10) | 0.48 |
| Precordial | 317 (21.5) | 0.27 (0.15–0.48) | 0.24 (0.12–0.46) | 0.30 (0.09–0.98) | 0.734 |
| Thorax, other parts | 396 (27.0) | 0.95 (0.67–1.37) | 1.05 (0.68–1.64) | 0.85 (0.45–1.60) | 0.579 |
| Shoulders or arms | 34 (2.3) | 0.72 (0.22–2.40) | 0.74 (0.17–3.26) | 0.73 (0.09–5.65) | 0.989 |
| Jaw or neck | 25 (1.7) | 1.45 (0.49–4.26) | 3.88 (0.91–16.4) | 0.64 (0.08–4.89) | 0.156 |
| Sum typical† location | 1391 (94.8) | 1.35 (0.61–2.98) | 1.60 (0.48–5.32) | 0.97 (0.33–2.83) | 0.543 |
| Epigastrial or abdominal | 81 (5.5) | 1.07 (0.54–2.11) | 0.81 (0.31–2.09) | 1.67 (0.62–4.49) | 0.298 |
| Other location‡ | 34 (2.3) | 0.22 (0.03–1.65) | – | 0.56 (0.07–4.30) | 0.999 |
| Sum atypical§ location | 77 (5.2) | 0.79 (0.42–1.51) | 0.57 (0.22–1.45) | 1.29 (0.53–3.18) | 0.217 |
| Character | |||||
| Tight/crushing | 960 (63.7) | 1.33 (0.82–2.14) | 1.44 (0.80–2.59) | 1.18 (0.51–2.75) | 0.706 |
| Dull/heavy | 81 (5.4) | 1.16 (0.59–2.32) | 0.73 (0.28–1.89) | 2.37 (0.85–6.58) | 0.098 |
| Sum typical¶ character | 1033 (68.6) | 1.48 (0.83–2.64) | 1.18 (0.62–2.26) | 3.37 (0.80–14.3) | 0.194 |
| Burning | 89 (5.9) | 2.21 (1.27–3.83) | 3.14 (1.61–6.10) | 1.14 (0.39–3.38) | 0.12 |
| Stinging | 218 (14.5) | 0.42 (0.23–0.77) | 0.34 (0.16–0.73) | 0.57 (0.20–1.64) | 0.448 |
| Other atypical | 2 (0.1) | – | – | – | 0.999 |
| Sum atypical** character | 299 (19.9) | 0.83 (0.54–1.28) | 0.82 (0.49–1.37) | 0.78 (0.35–1.74) | 0.932 |
| Unknown | 263 (17.5) | 1.40 (0.96–2.06) | 1.58 (1.01–2.47) | 0.95 (0.43–2.08) | 0.273 |
| Typical pain†† | 981 (66.8) | 1.52 (0.94–2.48) | 1.39 (0.78–2.50) | 1.99 (0.76–5.19) | 0.609 |
| Atypical pain‡‡ | 224 (15.3) | 0.66 (0.40–1.07) | 0.72 (0.40–1.29) | 0.50 (0.19–1.31) | 0.609 |
| Radiation | |||||
| Multiple directions | 298 (19.8) | 1.63 (1.13–2.34) | 1.62 (1.00–2.61) | 2.06 (1.14–3.73) | 0.532 |
| Both arms | 66 (4.4) | 9.40 (5.62–15.7) | 8.28 (4.44–15.4) | 11.7 (4.68–29.1) | 0.543 |
| Left arm | 296 (19.7) | 1.05 (0.71–1.56) | 1.05 (0.65–1.69) | 1.08 (0.54–2.17) | 0.939 |
| Right arm | 20 (1.7) | 0.86 (0.20–3.74) | 1.65 (0.35–7.87) | – | 0.999 |
| Both shoulders | 25 (1.7) | 1.97 (0.73–5.31) | 0.64 (0.08–5.01) | 4.49 (1.36–14.9) | 0.114 |
| Left or right shoulder | 92 (6.1) | 0.16 (0.04–0.67) | 0.14 (0.02–1.04) | 0.21 (0.03–1.58) | 0.776 |
| Jaw | 321 (21.3) | 1.41 (0.98–2.03) | 1.70 (1.06–2.70) | 1.34 (0.74–2.46) | 0.551 |
| Epigastrium or abdomen | 38 (2.5) | 1.18 (0.46–3.07) | 0.36 (0.05–2.71) | 2.96 (0.95–9.29) | 0.075 |
| Back | 189 (12.5) | 1.42 (0.92–2.20) | 1.71 (0.95–3.07) | 1.41 (0.71–2.80) | 0.677 |
| Numbness upper extremities | 128 (8.5) | 1.12 (0.65–1.94) | 1.07 (0.55–2.08) | 1.21 (0.46–3.22) | 0.827 |
| Any radiation | 789 (52.4) | 1.69 (1.21–2.35) | 1.82 (1.22–2.70) | 1.77 (0.93–3.34) | 0.937 |
| Unknown | 26 (1.7) | 2.33 (0.92–5.88) | 2.02 (0.65–6.29) | 3.01 (0.61–14.9) | 0.69 |
| Additional symptoms§§ | |||||
| Shortness of breath | 628 (41.7) | 1.06 (0.77–1.45) | 1.11 (0.75–1.64) | 1.05 (0.60–1.85) | 0.875 |
| Nausea | 318 (21.1) | 0.93 (0.63–1.37) | 1.01 (0.61–1.68) | 0.95 (0.50–1.80) | 0.88 |
| Vomiting | 43 (2.9) | 2.38 (1.15–4.93) | 2.33 (0.97–5.64) | 2.45 (0.68–8.89) | 0.951 |
| Diaphoresis or clamminess | 287 (19.1) | 1.79 (1.25–2.56) | 2.01 (1.32–3.06) | 1.19 (0.58–2.45) | 0.218 |
| Palpitations | 174 (11.6) | 0.69 (0.40–1.20) | 0.90 (0.47–1.75) | 0.47 (0.16–1.33) | 0.298 |
| Dizziness | 226 (15.0) | 0.38 (0.21–0.70) | 0.43 (0.21–0.91) | 0.35 (0.12–0.98) | 0.732 |
| Sum typical¶¶ add. symptoms | 1005 (66.7) | 0.98 (0.70–1.37) | 1.11 (0.75–1.66) | 0.84 (0.45–1.56) | 0.452 |
| Dependent of position | 124 (8.2) | 0.43 (0.20–0.94) | 0.17 (0.04–0.71) | 1.10 (0.42–2.90) | 0.033 |
| Dependent of respiration | 149 (9.9) | 0.19 (0.07–0.52) | 0.13 (0.03–0.55) | 0.33 (0.08–1.39) | 0.384 |
| Pain on palpation | 177 (11.8) | 0.38 (0.19–0.75) | 0.21 (0.07–0.69) | 0.69 (0.29–1.66) | 0.117 |
| Sum atypical*** add. symptoms | 351 (23.3) | 0.28 (0.16–0.48) | 0.17 (0.07–0.39) | 0.53 (0.25–1.11) | 0.047 |
| Effect of NG | 268 (17.8) | 1.78 (1.24–2.57) | 1.49 (0.71–3.13) | 1.57 (0.57–4.31) | 0.936 |
| Onset of symptoms | |||||
| During physical activity | 285 (18.9) | 2.91 (2.06–4.10) | 2.63 (1.74–3.96) | 3.29 (1.75–6.19) | 0.559 |
| After physical activity | 72 (4.8) | 1.27 (0.64–2.52) | 1.02 (0.42–2.47) | 1.86 (0.62–5.60) | 0.405 |
| Acute/chronic stress | 115 (7.6) | 0.26 (0.10–0.72) | 0.10 (0.01–0.71) | 0.62 (0.19–2.07) | 0.118 |
| During rest | 1027 (68.2) | 0.50 (0.36–0.69) | 0.56 (0.38–0.83) | 0.41 (0.23–0.73) | 0.4 |
| Unknown | 18 (1.2) | 2.98 (1.05–8.45) | 5.30 (1.40–20.0) | 1.29 (0.16–10.5) | 0.264 |
| Symptom duration | |||||
| <30 min | 377 (25.0) | 0.91 (0.62–1.33) | 0.98 (0.62–1.55) | 0.77 (0.39–1.53) | 0.559 |
| 30–60 min | 84 (5.6) | 1.36 (0.73–2.53) | 2.87 (1.45–5.69) | – | 0.997 |
| 60 min to 24 hours | 482 (32.0) | 1.44 (1.02–2.04) | 1.12 (0.74–1.71) | 2.37 (1.28–4.39) | 0.05 |
| >24 hours | 155 (10.3) | 0.13 (0.04–0.40) | – | 0.60 (0.18–2.00) | 0.996 |
| Terminated by NG | 88 (5.8) | 1.55 (0.86–2.78) | 1.53 (0.76–3.05) | 1.50 (0.50–4.50) | 0.979 |
| Terminated by morphine | 37 (2.5) | 0.88 (0.31–2.51) | 1.26 (0.36–4.44) | 0.52 (0.07–3.95) | 0.463 |
| Unknown | 283 (18.8) | 0.77 (0.50–1.18) | 0.85 (0.51–1.42) | 0.61 (0.27–1.38) | 0.491 |
| Intensity of pain in intervals††† | 1506 (100) | 1.56 (1.19–2.04) | 1.84 (1.28–2.63) | 1.21 (0.80–1.84) | 0.141 |
| Last 24 hours | |||||
| Exertional chest pain >once | 48 (3.2) | 1.80 (0.86–3.77) | 1.12 (0.42–2.94) | 4.36 (1.32–14.4) | 0.083 |
| Last week | |||||
| Exertional chest pain | 268 (17.8) | 3.00 (2.13–4.26) | 2.77 (1.84–4.18) | 3.25 (1.73–6.10) | 0.679 |
| Shortness of breath | 60 (4.0) | 1.36 (0.66–2.82) | 1.20 (0.45–3.19) | 1.77 (0.59–5.30) | 0.607 |
| Pain similar to previous AMI | 57 (3.8) | 0.72 (0.29–1.84) | 0.45 (0.14–1.47) | 2.09 (0.45–9.82) | 0.12 |
Statistically significant differences highlighted
*In patients having chest pain at presentation.
†Summation of traditionally considered typical pain location like retrosternal, precordial, other parts of thorax, shoulder, arms, jaw or neck.
‡Summation of pain in the back and all other non-typical locations.
§Summation of traditionally considered atypical pain location like epigastrium, abdomen, back or other locations.
¶Summation of traditionally considered typical pain character like tight, crushing, dull or heavy.
**Summation of traditionally considered atypical pain character like burning, stinging or other.
††Typical pain is defined as the combination of traditionally considered typical location and character.
‡‡Atypical pain is defined as either atypical location or character, or both.
§§ If not stated considered negative.
¶¶ Summation of traditionally considered typical additional symptoms like shortness of breath, nausea, vomiting. diaphoresis, clamminess, palpitations or dizziness.
*** Summation of traditionally considered atypical additional symptoms like pain dependent of position, respiration or palpation.
†††Four groups; no pain; Visual analogue scale (VAS) 1–3.5; VAS 3.5–6.5; VAS >6.5.
AMI, acute myocardial infarction; NG, Nitroglycerin; NSTEMI, non-ST segment elevation myocardial infarction.