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Background <p>Sweating in individuals with suspected cardiac chest pain indicates a greater risk of experiencing ST-segment elevation myocardial infarction (STEMI). Nevertheless, the relationship between sweating and clinical outcomes remains inadequately explored.</p> Methods <p>From 2013 through 2016, 19112 patients with STEMI enrolled in the China Acute Myocardial Infarction registry. Heavy sweating was evaluated on admission and usually judged by dampen clothing. Thrombolysis in Myocardial Infarction (TIMI) flow and ST-segment resolution (STR) were used to evaluated the myocardial reperfusion after primary percutaneous myocardial infarction (PCI). The primary outcome was all-cause death during hospitalization and at 24 months.</p> Results <p>Thirteen thousand, four hundred twenty-two patients (70.2%) presented heavy sweating, that was associated with age &lt; 65 years, severe chest pain, current smoking status, and heart rates &lt; 100 bpm on admission. Heavy sweating group was more likely to achieve primary PCI (44.7% vs 32.9%) but shown similar rates of post-PCI TIMI 3 flow (95.5% vs 94.1%) and STR ≥ 50% (79.8% vs 78.2%). After multivariable analysis, heavy sweating was significantly linked to lower in-hospital (5.9% vs 8.6%, odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.72–0.92) and 24-month mortality (11.0% vs 17.2%, hazard ratio [HR]: 0.75, 95% CI: 0.69–0.82). Even among patients undergoing primary PCI who achieved successful myocardial reperfusion, this short- (2.5% vs 4.2%, OR: 0.60, 95% CI: 0.45–0.80) and long-term (5.9% vs 8.7%, HR: 0.68, 95% CI: 0.56–0.83) prognostic significance remained robust.</p> Conclusions <p>For STEMI, the presence of heavy sweating was associated with lower mortality regardless of successful primary PCI, which highlight the potential for early risk stratification based on the sweating presentation.</p> Trial registration <p>https//www.clinicaltrials.gov. Unique identifier: NCT01874691. Registered 11/06/2013.</p>

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Role of heavy sweating for ST-segment elevation myocardial infarction: analysis of the China Acute Myocardial Infarction registry

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  • 发表日期：

    2025年5月20日

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  • Chao Wu,
  • Zilong Zhang,
  • Shuhong Su,
  • Haiyan Xu,
  • Lei Song,
  • Yongjian Wu,
  • Shubin Qiao,
  • Yang Wang,
  • Wei Li,
  • Yida Tang,
  • Xiaojin Gao,
  • Jingang Yang,
  • Yuejin Yang,
  • Yuan Wu,
  • Hongwei Li,
  • Changlin Lu,
  • Shujun Cao,
  • Dezhao Wang,
  • Guanglin Wei,
  • Jianbing Wang,
  • Ruiyan Zhang,
  • Yawei Xu,
  • Zengyong Qiao,
  • Zheng Wan,
  • Yanjun Cao,
  • Yaohui Yin,
  • Weiming Li,
  • Shuqing Wang,
  • Gang Ma,
  • Yongchen Cai,
  • Yang Zheng,
  • Xuxia Zhang,
  • Hongyan Guo,
  • Xiaozeng Wang,
  • Ling Sun,
  • Jianhua Wu,
  • Fengying Chen,
  • Ronghai Man,
  • Yanjie Li,
  • Xianghua Fu,
  • Qingshen Wang,
  • Liying Zhang,
  • Xiaoli Gao,
  • Yali Hu,
  • Qun Zheng,
  • Bao Li,
  • Yuping zhang,
  • Yaohong Dong,
  • Chuanyu Gao,
  • Zhoushun Qin,
  • Guorui Hou,
  • Lingling Liu,
  • Shifeng Ren,
  • Dezhou wang,
  • Xianting Luan,
  • Hui Liu,
  • Liping Ma,
  • Chuntong Wang,
  • Zuyi Yuan,
  • Junnong Li,
  • Yaofeng Yuan,
  • Huide Liu,
  • Shaobin jia,
  • Xianghong Luo,
  • Yin Liu,
  • Pinfa Liu,
  • Xianning Zhao,
  • Bao Ma,
  • Yitong Ma,
  • Mao Wang,
  • Shiming Gao,
  • Hang Lu,
  • Lianqun Cui,
  • Huanyi Zhang,
  • Hongyan Zhang,
  • Biao Xu,
  • Shenghu He,
  • Qiang Fu,
  • Shihai Shen,
  • Likun Ma,
  • Bin Ning,
  • Jili Fan,
  • Yong Sun,
  • Lijiang tang,
  • Danlei Xu,
  • Lianglong Chen,
  • Yan Wang,
  • Ping chen,
  • Kaihong Chen,
  • Daowen wang,
  • Shuixian peng,
  • Shuping Wan,
  • Laxi Zhang,
  • Shenhua Zhou,
  • Jianping Zeng,
  • Chonglun Zhou,
  • Haibo zhang,
  • Dechao Zhong,
  • Yuquan Xiao,
  • Lang Li,
  • Hai Zhu,
  • Meisheng Lai,
  • Xiaoshu Cheng,
  • Junming Ye,
  • Qishou Liu,
  • Tianhe Yang,
  • Zhengqiang Yuan,
  • Chengyuan Zhao,
  • Xianwen Jiang,
  • Jiyan Chen,
  • Wei Wu,
  • Gaoxing Zhang,
  • Haiyuan Mai,
  • Tao Guo,
  • Yi Li,
  • Xiaoming Liu,
  • Jinlong Xu,
  • Gesang Luobu,
  • Bin Li,
  • Tiansong Wang,
  • Dong Wang

摘要

Background

Sweating in individuals with suspected cardiac chest pain indicates a greater risk of experiencing ST-segment elevation myocardial infarction (STEMI). Nevertheless, the relationship between sweating and clinical outcomes remains inadequately explored.

Methods

From 2013 through 2016, 19112 patients with STEMI enrolled in the China Acute Myocardial Infarction registry. Heavy sweating was evaluated on admission and usually judged by dampen clothing. Thrombolysis in Myocardial Infarction (TIMI) flow and ST-segment resolution (STR) were used to evaluated the myocardial reperfusion after primary percutaneous myocardial infarction (PCI). The primary outcome was all-cause death during hospitalization and at 24 months.

Results

Thirteen thousand, four hundred twenty-two patients (70.2%) presented heavy sweating, that was associated with age < 65 years, severe chest pain, current smoking status, and heart rates < 100 bpm on admission. Heavy sweating group was more likely to achieve primary PCI (44.7% vs 32.9%) but shown similar rates of post-PCI TIMI 3 flow (95.5% vs 94.1%) and STR ≥ 50% (79.8% vs 78.2%). After multivariable analysis, heavy sweating was significantly linked to lower in-hospital (5.9% vs 8.6%, odds ratio [OR]: 0.81, 95% confidence interval [CI]: 0.72–0.92) and 24-month mortality (11.0% vs 17.2%, hazard ratio [HR]: 0.75, 95% CI: 0.69–0.82). Even among patients undergoing primary PCI who achieved successful myocardial reperfusion, this short- (2.5% vs 4.2%, OR: 0.60, 95% CI: 0.45–0.80) and long-term (5.9% vs 8.7%, HR: 0.68, 95% CI: 0.56–0.83) prognostic significance remained robust.

Conclusions

For STEMI, the presence of heavy sweating was associated with lower mortality regardless of successful primary PCI, which highlight the potential for early risk stratification based on the sweating presentation.

Trial registration

https//www.clinicaltrials.gov. Unique identifier: NCT01874691. Registered 11/06/2013.