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

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.