BackgroundTo the best of our knowledge, there are no studies evaluating the influence
of the unit of the first contact on the frequency and time of
pharmacological treatment during an acute coronary syndrome (ACS) event.ObjectivesThe main objective was to investigate if the unit of first contact influenced
the frequency and time of aspirin treatment in the Strategy of Registry of
Acute Coronary Syndrome (ERICO) study.MethodsWe analyzed the pharmacological treatment time in 830 ERICO participants -
700 individuals for whom the hospital was the unit of first contact and 130
who initially sought primary care units. We built logistic regression models
to study whether the unit of first contact was associated with a treatment
time of less than three hours.ResultsIndividuals who went to primary care units received the first aspirin dose in
those units in 75.6% of the cases. The remaining 24.4% received aspirin at
the hospital. Despite this finding, individuals from primary care still had
aspirin administered within three hours more frequently than those who went
to the hospital (76.8% vs 52.6%; p<0.001 and 100% vs. 70.7%; p=0.001 for
non ST-elevation ACS and ST-elevation myocardial infarction, respectively).
In adjusted models, individuals coming from primary care were more likely to
receive aspirin more quickly (odds ratio: 3.66; 95% confidence interval:
2.06-6.51).ConclusionsIn our setting, individuals from primary care were more likely to receive
aspirin earlier. Enhancing the ability of primary care units to provide
early treatment and safe transportation may be beneficial in similar
settings.