Patient and system delays in the treatment of acute coronary syndrome

Viana, Marta; Laszczyńska, Olga; Araújo, Carla; Borges, Andreia; Barros, Vítor; Ribeiro, Ana Isabel; Dias, Paula; Maciel, Maria Júlia; Moreira, Ilídio; Lunet, Nuno; Azevedo, Ana

doi:10.1016/j.repc.2019.07.007

Cited by 11 publications

(8 citation statements)

References 33 publications

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“…Candiello et al 12 reported the median FMC delay time in their study as 75 minutes, while Pereira et al 13 reported as 114 minutes. In the study of Viana et al, 10 the STEMI rate with FMC delay below 120 minutes was found to be 56.7%. In our study, in order to understand the patient‐related delay better, we calculated another time that we defined as home delay in addition to FMC delay.…”

Section: Discussionmentioning

confidence: 89%

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Effect of Covid‐19 pandemic process on STEMI patients timeline

Soylu

Çoksevim

Yanık

et al. 2021

Int. J. Clin. Pract.

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Objective Delayed revascularisation in patients with ST‐segment elevation myocardial infarction (STEMI) is associated with poor prognosis. The aim of this study is to investigate how the timeline in STEMI treatment was affected during the Covid‐19 outbreak. Method Consecutive 165 STEMI patients were enrolled in the study during the Covid‐19 pandemic period (Pandemic period) and the prepandemic period (Control period). The time period until patients' leaving their current position after the onset of pain (home delay), the time from the onset of pain to the first medical contact (FMC delay), door‐to‐balloon time, procedure time and hospitalisation time were recorded. Results A total of 165 patients, 82 in the Pandemic period and 83 in the Control period, were included in the study. When compared with the control period, home delay [30 (5‐6912) minutes vs 165 (10‐360) minutes, P < .001] and FMC delay [61 (20‐6932) minutes vs 190 (15‐3660) minutes, P < .001] were significantly prolonged during the pandemic period. In addition, non‐IRA PCI rate (8.8% vs 19.3% P = .043) and hospitalisation time [71 (15‐170) vs 74.2 (37‐329) hours, P = .045] were decreased. Conclusion During the Covid‐19 pandemic period, prolonged prehospital time parameters were observed in STEMI patients. Therefore, additional measures may be required to prevent unfavourable delays in STEMI patients during the outbreak.

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Section: Discussionmentioning

confidence: 89%

“…Studies have shown that the delay in FMC is associated with an increase in mortality and complication rate 10,11 . Candiello et al 12 reported the median FMC delay time in their study as 75 minutes, while Pereira et al 13 reported as 114 minutes.…”

Section: Discussionmentioning

confidence: 92%

Effect of Covid‐19 pandemic process on STEMI patients timeline

Soylu

Çoksevim

Yanık

et al. 2021

Int. J. Clin. Pract.

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“…ACS is a time-critical condition, which means delays in diagnosis and treatment of the disease can upsurge the risk of heart muscle damage, leading to increased morbidity and mortality [ 1 , 5 , 6 ]. Several patient and service level factors have been identified as affecting the timely diagnosis and treatment of ACS; among them are the patient’s hesitation and delay in seeking medical care is a key factor [ 7 ]. Mirzaei et al found that lack of recognition of ACS symptoms, the discrepancy between actual and expected symptoms, and discrepancy between current symptoms and previous experience of the disease are some factors contributing to delay in timely treatment seeking [ 6 ].…”

Section: Introductionmentioning

confidence: 99%

Symptom recognition and treatment-seeking behaviors in women experiencing acute coronary syndrome for the first time: a qualitative study

Asghari

Gholizadeh

Kazami³

et al. 2022

BMC Cardiovasc Disord

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Background Women are more likely to delay medical help-seeking for ACS symptoms. Understanding patients’ experience of the symptoms and their response is essential in improving help-seeking behaviors and timely diagnosis and treatment for ACS. This study aimed to explore women’s experience of ACS, their response to the symptoms, and treatment-seeking decisions. Methods This qualitative descriptive study was conducted in a tertiary referral specialized heart hospital affiliated with Tabriz University of Medical Sciences, Iran. Participants included 39 women who had experienced ACS for the first time. Results Four main themes emerged from the analysis of interview transcripts: (1) the onset of symptoms, (2) the types of symptoms, (3) response to symptoms and (4) arriving at the hospital. These themes and associated sub-themes explained women’s experience of ACS symptoms, their response to the symptoms, and decision to seek medical help. Conclusions This study identified and discussed factors contributing to the prehospital delay in women and their decision-making to seek medical care for ACS symptoms. The results are consistent with previous research indicating that ACS symptoms in women are somewhat different from men, and women tend to underestimate their symptoms and attribute them to non-cardiac causes. Women should be supported to develop awareness and understanding of ACS symptoms and appreciate the importance of early treatment-seeking in the disease outcomes.

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“…As is well known, cardiovascular diseases are the leading cause of adult death in China [6]. Acute myocardial infarction is a disease that requires race against time, with treatment that should be administered within minutes [7]. On January 27, 2020, the Hangzhou CPC developed an ST-segment elevation myocardial infarction (STEMI) treatment process for this special period ( E-mail addresses: 495086736@qq.com (Z. Xu), wmw990556@163.com (M.-W. Wang) , hsdzxw@126.com (X. Zhang).…”

Section: Introductionmentioning

confidence: 99%

Effect of COVID-19 outbreak on the treatment time of patients with acute ST-segment elevation myocardial infarction

Shen

Cheng

et al. 2021

The American Journal of Emergency Medicine

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Objective: To explore the effect of COVID-19 outbreak on the treatment time of patients with ST-segment elevation myocardial infarction (STEMI) in Hangzhou, China. Methods: We retrospectively reviewed the data of STEMI patients admitted to the Hangzhou Chest Pain Center (CPC) during a COVID-19 epidemic period in 2020 (24 cases) and the same period in 2019 (29 cases). General characteristics of the patients were recorded, analyzed, and compared. Moreover, we compared the groups for the time from symptom onset to the first medical contact (SO-to-FMC), time from first medical contact to balloon expansion (FMC-to-B), time from hospital door entry to first balloon expansion (D-to-B), and catheter room activation time. The groups were also compared for postoperative cardiac color Doppler ultrasonographic left ventricular ejection fraction (LVEF),the incidence of major adverse cardiovascular and cerebrovascular events (MACCE),Kaplan-Meier survival curves during the 28 days after the operation. Results: The times of SO-to-FMC, D-to-B, and catheter room activation in the 2020 group were significantly longer than those in the 2019 group (P < 0.05). The cumulative mortality after the surgery in the 2020 group was significantly higher than the 2019 group (P < 0.05). Conclusion: The pre-hospital and in-hospital treatment times of STEMI patients during the COVID-19 epidemic were longer than those before the epidemic. Cumulative mortality was showed in Kaplan-Meier survival curves after the surgery in the 2020 group was significantly different higher than the 2019 group during the 28 days.The diagnosis and treatment process of STEMI patients during an epidemic should be optimized to improve their prognosis.

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Patient and system delays in the treatment of acute coronary syndrome

Cited by 11 publications

References 33 publications

Effect of Covid‐19 pandemic process on STEMI patients timeline

Effect of Covid‐19 pandemic process on STEMI patients timeline

Symptom recognition and treatment-seeking behaviors in women experiencing acute coronary syndrome for the first time: a qualitative study

Effect of COVID-19 outbreak on the treatment time of patients with acute ST-segment elevation myocardial infarction

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