Table 3

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 pain1468 (97.5)1.55 (0.47–5.09)2.05 (0.48–8.75)0.97 (0.12–7.76)0.565
Location*
Retrosternal661 (45.0)2.09 (1.51–2.89)2.24 (1.51–3.34)1.75 (0.98–3.10)0.48
Precordial317 (21.5)0.27 (0.15–0.48)0.24 (0.12–0.46)0.30 (0.09–0.98)0.734
Thorax, other parts396 (27.0)0.95 (0.67–1.37)1.05 (0.68–1.64)0.85 (0.45–1.60)0.579
Shoulders or arms34 (2.3)0.72 (0.22–2.40)0.74 (0.17–3.26)0.73 (0.09–5.65)0.989
Jaw or neck25 (1.7)1.45 (0.49–4.26)3.88 (0.91–16.4)0.64 (0.08–4.89)0.156
Sum typical† location1391 (94.8)1.35 (0.61–2.98)1.60 (0.48–5.32)0.97 (0.33–2.83)0.543
Epigastrial or abdominal81 (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§ location77 (5.2)0.79 (0.42–1.51)0.57 (0.22–1.45)1.29 (0.53–3.18)0.217
Character
Tight/crushing960 (63.7)1.33 (0.82–2.14)1.44 (0.80–2.59)1.18 (0.51–2.75)0.706
Dull/heavy81 (5.4)1.16 (0.59–2.32)0.73 (0.28–1.89)2.37 (0.85–6.58)0.098
Sum typical¶ character1033 (68.6)1.48 (0.83–2.64)1.18 (0.62–2.26)3.37 (0.80–14.3)0.194
Burning89 (5.9)2.21 (1.27–3.83)3.14 (1.61–6.10)1.14 (0.39–3.38)0.12
Stinging218 (14.5)0.42 (0.23–0.77)0.34 (0.16–0.73)0.57 (0.20–1.64)0.448
Other atypical2 (0.1)0.999
Sum atypical** character299 (19.9)0.83 (0.54–1.28)0.82 (0.49–1.37)0.78 (0.35–1.74)0.932
Unknown263 (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 directions298 (19.8)1.63 (1.13–2.34)1.62 (1.00–2.61)2.06 (1.14–3.73)0.532
Both arms66 (4.4)9.40 (5.62–15.7)8.28 (4.44–15.4)11.7 (4.68–29.1)0.543
Left arm296 (19.7)1.05 (0.71–1.56)1.05 (0.65–1.69)1.08 (0.54–2.17)0.939
Right arm20 (1.7)0.86 (0.20–3.74)1.65 (0.35–7.87)0.999
Both shoulders25 (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 shoulder92 (6.1)0.16 (0.04–0.67)0.14 (0.02–1.04)0.21 (0.03–1.58)0.776
Jaw321 (21.3)1.41 (0.98–2.03)1.70 (1.06–2.70)1.34 (0.74–2.46)0.551
Epigastrium or abdomen38 (2.5)1.18 (0.46–3.07)0.36 (0.05–2.71)2.96 (0.95–9.29)0.075
Back189 (12.5)1.42 (0.92–2.20)1.71 (0.95–3.07)1.41 (0.71–2.80)0.677
Numbness upper extremities128 (8.5)1.12 (0.65–1.94)1.07 (0.55–2.08)1.21 (0.46–3.22)0.827
Any radiation789 (52.4)1.69 (1.21–2.35)1.82 (1.22–2.70)1.77 (0.93–3.34)0.937
Unknown26 (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 breath628 (41.7)1.06 (0.77–1.45)1.11 (0.75–1.64)1.05 (0.60–1.85)0.875
Nausea318 (21.1)0.93 (0.63–1.37)1.01 (0.61–1.68)0.95 (0.50–1.80)0.88
Vomiting43 (2.9)2.38 (1.15–4.93)2.33 (0.97–5.64)2.45 (0.68–8.89)0.951
Diaphoresis or clamminess287 (19.1)1.79 (1.25–2.56)2.01 (1.32–3.06)1.19 (0.58–2.45)0.218
Palpitations174 (11.6)0.69 (0.40–1.20)0.90 (0.47–1.75)0.47 (0.16–1.33)0.298
Dizziness226 (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. symptoms1005 (66.7)0.98 (0.70–1.37)1.11 (0.75–1.66)0.84 (0.45–1.56)0.452
Dependent of position124 (8.2)0.43 (0.20–0.94)0.17 (0.04–0.71)1.10 (0.42–2.90)0.033
Dependent of respiration149 (9.9)0.19 (0.07–0.52)0.13 (0.03–0.55)0.33 (0.08–1.39)0.384
Pain on palpation177 (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. symptoms351 (23.3)0.28 (0.16–0.48)0.17 (0.07–0.39)0.53 (0.25–1.11)0.047
Effect of NG268 (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 activity285 (18.9)2.91 (2.06–4.10)2.63 (1.74–3.96)3.29 (1.75–6.19)0.559
After physical activity72 (4.8)1.27 (0.64–2.52)1.02 (0.42–2.47)1.86 (0.62–5.60)0.405
Acute/chronic stress115 (7.6)0.26 (0.10–0.72)0.10 (0.01–0.71)0.62 (0.19–2.07)0.118
During rest1027 (68.2)0.50 (0.36–0.69)0.56 (0.38–0.83)0.41 (0.23–0.73)0.4
Unknown18 (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 min377 (25.0)0.91 (0.62–1.33)0.98 (0.62–1.55)0.77 (0.39–1.53)0.559
30–60 min84 (5.6)1.36 (0.73–2.53)2.87 (1.45–5.69)0.997
60 min to 24 hours482 (32.0)1.44 (1.02–2.04)1.12 (0.74–1.71)2.37 (1.28–4.39)0.05
>24 hours155 (10.3)0.13 (0.04–0.40)0.60 (0.18–2.00)0.996
Terminated by NG88 (5.8)1.55 (0.86–2.78)1.53 (0.76–3.05)1.50 (0.50–4.50)0.979
Terminated by morphine37 (2.5)0.88 (0.31–2.51)1.26 (0.36–4.44)0.52 (0.07–3.95)0.463
Unknown283 (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 >once48 (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 pain268 (17.8)3.00 (2.13–4.26)2.77 (1.84–4.18)3.25 (1.73–6.10)0.679
Shortness of breath60 (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 AMI57 (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.