{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,30]],"date-time":"2026-06-30T10:45:54Z","timestamp":1782816354825,"version":"3.54.5"},"reference-count":23,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T00:00:00Z","timestamp":1780531200000},"content-version":"vor","delay-in-days":3,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,6,1]],"date-time":"2026-06-01T00:00:00Z","timestamp":1780272000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100000925","name":"National Health and Medical Research Council","doi-asserted-by":"publisher","award":["APP1193269"],"award-info":[{"award-number":["APP1193269"]}],"id":[{"id":"10.13039\/501100000925","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100002076","name":"Emergency Medicine Foundation","doi-asserted-by":"publisher","award":["EMLE\u2010122R31\u20102019"],"award-info":[{"award-number":["EMLE\u2010122R31\u20102019"]}],"id":[{"id":"10.13039\/100002076","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001030","name":"National Heart Foundation of Australia","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100001030","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Emerg Medicine Australasia"],"published-print":{"date-parts":[[2026,6]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study examines the symptoms experienced by patients investigated for Acute Coronary Syndrome (ACS). It aims to determine whether symptom clusters exist, whether these predict acute myocardial infarction (AMI), and whether symptom patterns differ between Aboriginal and Torres Strait Islander people and non\u2010Indigenous Australians.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This analysis of the LEGEND trial included 2185 patients (22.7% of whom identified as Aboriginal and Torres Strait Islander). Data on presenting symptoms and outcomes were collected from patient medical records. Regression analyses examined whether individual symptoms predicted AMI for Aboriginal and Torres Strait Islander and non\u2010Indigenous patients. Factor analysis identified symptom clusters. Regression analyses estimated the associations between each symptom cluster and AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Six symptom clusters were identified: pleuritic, numbness, anginal, palpitations, epigastric, and infectious. Anginal was most strongly associated with AMI (Risk ratio [RR]\u2009=\u20091.46; 95% CI: 1.31\u20131.62), while pleuritic was linked to a reduced risk (RR\u2009=\u20090.47; 95% CI: 0.35\u20130.62). Numbness (RR\u2009=\u20091.29; 95% CI: 1.11\u20131.49) and infectious (RR\u2009=\u20091.21; 95% CI: 1.05\u20131.41) were associated with an increased AMI risk. There were individual symptoms that differed for Aboriginal and Torres Strait Islander patients. However, cluster\u2010level predictive performance was similar across groups. No symptom cluster provided sufficient discriminatory power to rule in or rule out AMI.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Symptom presentation in AMI is heterogeneous, and reliance on \u201cclassic\u201d symptoms alone may miss at\u2010risk patients. While some differences in individual symptom associations were observed for Aboriginal and Torres Strait Islander patients, overall cluster patterns were comparable.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/1742-6723.70269","type":"journal-article","created":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T07:47:10Z","timestamp":1780559230000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Identifying Symptom Clusters Predictive of Acute Myocardial Infarction for Aboriginal and Torres Strait Islander and Non\u2010Indigenous Australians"],"prefix":"10.1111","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6970-5573","authenticated-orcid":false,"given":"Jaimi","family":"Greenslade","sequence":"first","affiliation":[{"name":"School of Clinical Sciences, Faculty of Health Queensland University of Technology  Turrbal and Yuggera Country Queensland Australia"},{"name":"Emergency and Trauma Centre Royal Brisbane and Women's Hospital  Turrbal and Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William","family":"Parsonage","sequence":"additional","affiliation":[{"name":"The Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health Queensland University of Technology  Turrbal and Yuggera Country Queensland Australia"},{"name":"Department of Cardiology Royal Brisbane and Women's Hospital  Turrbal and Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9976-3846","authenticated-orcid":false,"given":"Laura","family":"Stephensen","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre Royal Brisbane and Women's Hospital  Turrbal and Yuggera Country Queensland Australia"},{"name":"The Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health Queensland University of Technology  Turrbal and Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeremy","family":"Rigney","sequence":"additional","affiliation":[{"name":"Emergency Department Cairns Hospital, Cairns, Gimuy  Waluburra Yidinji Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katrina","family":"Starmer","sequence":"additional","affiliation":[{"name":"Emergency Department Cairns Hospital, Cairns, Gimuy  Waluburra Yidinji Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gregory","family":"Starmer","sequence":"additional","affiliation":[{"name":"Department of Cardiology Cairns Hospital, Cairns, Gimuy  Waluburra Yidinji Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Virginia","family":"Campbell","sequence":"additional","affiliation":[{"name":"Emergency Department Cairns Hospital, Cairns, Gimuy  Waluburra Yidinji Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emma","family":"Hall","sequence":"additional","affiliation":[{"name":"Emergency Department Gold Coast University Hospital, Land of the Kombumerri Peoples, Part of the Yugambeh Language Region  Southport Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Niranjan","family":"Gaikwad","sequence":"additional","affiliation":[{"name":"Department of Cardiology The Prince Charles Hospital, Chermside, Turrbal  Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siegfried","family":"Perez","sequence":"additional","affiliation":[{"name":"Emergency Department Logan Hospital, Meadowbrook, Turrbal  Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Louise","family":"Cullen","sequence":"additional","affiliation":[{"name":"Emergency and Trauma Centre Royal Brisbane and Women's Hospital  Turrbal and Yuggera Country Queensland Australia"},{"name":"The Australian Centre for Health Services Innovation, Centre for Healthcare Transformation, School of Public Health and Social Work, Faculty of Health Queensland University of Technology  Turrbal and Yuggera Country Queensland Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the Legend investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,6,4]]},"reference":[{"key":"e_1_2_10_2_1","unstructured":"Australian Institute of Health and Welfare \u201cMeasure 1.05 Cardiovascular Disease Aboriginal and Torres Strait Island Health Performance Framework Website: AIHW 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Evaluation and Diagnosis of CHEST Pain: A Report of the American College of Cardiology\/American Heart Association Joint Committee on Clinical Practice Guidelines","volume":"144","author":"Gulati M.","year":"2021","journal-title":"Circulation"},{"key":"e_1_2_10_21_1","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartjsupp\/suac122"},{"key":"e_1_2_10_22_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tmaid.2024.102793"},{"key":"e_1_2_10_23_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja17.00250"},{"key":"e_1_2_10_24_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.hlc.2010.02.011"}],"container-title":["Emergency Medicine 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