Non-Cardiac Chest Pain After Acute Myocardial Infarction: Frequency and Association with Health Status Outcomes

Background The frequency of non-cardiac chest pain (CP) hospitalization after acute myocardial infarction (AMI) is unknown, and its significance from patients' perspectives is not studied. Objectives To assess the frequency of non-cardiac CP admissions after AMI and its association with patients' self-reported health status. Methods We identified cardiac and non-cardiac CP hospitalizations in the year after AMI from the 24-center TRIUMPH registry. Hierarchical repeated measures regression was used to identify the association of these hospitalizations with patients' self-reported health status using the Seattle Angina Questionnaire Quality of Life domain (SAQ QoL) and Short Form 12 (SF-12) physical (PCS) and mental (MCS) component summary scores. Results Of 3099 patients, 318 (10.3%) were hospitalized with CP, of whom 92 (28.9%) were hospitalized for non-cardiac CP. Compared with patients not hospitalized with CP, non-cardiac CP hospitalization was associated with poorer health status (SAQ QoL adjusted differences: −8.9 points [95% CI -12.1, −5.6]; SF-12 PCS: -2.5 points [95% CI -4.2, −0.8] and SF-12 MCS: -3.5 points [95% CI -5.1, −1.9]). SAQ QoL for patients hospitalized with non-cardiac CP was similar to patients hospitalized with cardiac CP (adjusted difference: 0.6 points [95% CI -3.2, 4.5]; SF-12 PCS (0.9 points [95% CI -1.1, 2.9]), but was worse with regards to SF-12 MCS (adjusted difference: −2.0 points [95% CI -3.9, −0.2]). Conclusions Non-cardiac CP accounted for a third of CP hospitalizations within one year of AMI and was associated with similar disease-specific QoL as well general physical and mental health status impairment compared with cardiac CP hospitalization.