The association between pre-infarction angina and care-seeking behaviors and its effects on early reperfusion rates for acute myocardial infarction

Yan, Hong‐Bin; Song, Li; Yang, Jae Wook; Sun, Yaxun; Hu, Dayi

doi:10.1016/j.ijcard.2008.09.002

Cited by 13 publications

(17 citation statements)

References 41 publications

(44 reference statements)

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“…In our study, median symptom-to-door time was 130.5 min, which is comparable to developed countries, such as Australia, with a pre-hospital delay time of 132 min (11), the United States (US) with 162 min (9), Korea with 150 min (13) and Beijing, China, with 110 min to 140 min (10, 14). Our median time was approximately 50% shorter compared to some developing countries, such as India (ranging from 250 min to 290 min) (7, 15).…”

Section: Discussionsupporting

confidence: 62%

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Lim

Rahman

Yaacob

2019

MJMS

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BackgroundPre-hospital delay is currently a major factor limiting early reperfusion among ST-elevation myocardial infarction (STEMI) patients worldwide. This study aims to determine pre-hospital factors affecting symptom-to-door time among STEMI patients in Malaysia.MethodsThis cross-sectional study included 222 STEMI patients admitted to two tertiary hospitals in Malaysia. By determining symptom-to-door time, the study population was categorised into two definitive treatment seeking groups: early (≤ 3 h) and delayed (> 3 h). Data was collected focusing on socio-demographical data, risk factors and comorbidities, clinical presentation, situational factors and action taken by patients.ResultsThe mean age of our patients was 58.0 (SD = 11.9) years old, and the population consisted of 186 (83.8%) males and 36 (16.2%) females. Our study found that the median symptom-to-door time was 130.5 (IQR 240) min, with 64% of subjects arriving early and 36% arriving late. Pre-hospital delays were found to be significant among females (adj OR = 2.42; 95% CI: 1.02, 5.76; P = 0.046), patients with recurrence of similar clinical presentations (adj OR = 2.74; 95% CI: 1.37, 5.46; P = 0.004), patients experiencing atypical symptoms (adj OR = 2.64; 95% CI: 1.11, 6.31; P = 0.029) and patients who chose to have their first medical contact (FMC) for their symptoms with a general practitioner (adj OR = 2.80; 95% CI: 1.20, 6.56; P = 0.018). However, patients with hyperlipidaemia (adj OR = 0.46; 95% CI: 0.23, 0.93; P = 0.030), self-perceived cardiac symptoms (adj OR = 0.36; 95% CI: 0.17, 0.73; P = 0.005) and symptoms that began in public places (adj OR = 0.21; 95% CI: 0.06, 0.69; P = 0.010) tended to seek treatment earlier.ConclusionThe symptom-to-door time among the Malaysian population is shorter in comparison to other developing countries. Nevertheless, identified, modifiable pre-hospital factors can be addressed to further shorten symptom-to-door time among STEMI patients.

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Section: Discussionsupporting

confidence: 62%

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Lim

Rahman

Yaacob

2019

MJMS

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“…A history of hypertension [ 36 ], as well as diabetes [ 33 - 35 , 37 ], has been shown to be associated with a prolonged pre-hospital delay. Furthermore, the presence of pre-infarction angina has been associated with a longer pre-hospital delay [ 103 ].…”

Section: The Reviewmentioning

confidence: 99%

Early identification and delay to treatment in myocardial infarction and stroke: differences and similarities

Herlitz

Wireklint-Sundström

Bång

et al. 2010

Scand J Trauma Resusc Emerg Med

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BackgroundThe two major complications of atherosclerosis are acute myocardial infarction (AMI) and acute ischemic stroke. Both are life-threatening conditions characterised by the abrupt cessation of blood flow to respective organs, resulting in an infarction. Depending on the extent of the infarction, loss of organ function varies considerably.In both conditions, it is possible to limit the extent of infarction with early intervention. In both conditions, minutes count.This article aims to describe differences and similarities with regard to the way patients, bystanders and health care providers act in the acute phase of the two diseases with the emphasis on the pre-hospital phase.MethodA literature search was performed on the PubMed, Embase (Ovid SP) and Cochrane Library databases.ResultsIn both conditions, symptoms vary considerably. Patients appear to suspect AMI more frequently than stroke and, in the former, there is a gender gap (men suspect AMI more frequently than women).With regard to detection of AMI and stroke at dispatch centre and in Emergency Medical Service (EMS) there is room for improvement in both conditions. The use of EMS appears to be higher in stroke but the overall delay to hospital admission is shorter in AMI. In both conditions, the fast track concept has been shown to influence the delay to treatment considerably.In terms of diagnostic evaluation by the EMS, more supported instruments are available in AMI than in stroke. Knowledge of the importance of early treatment has been reported to influence delays in both AMI and stroke.ConclusionBoth in AMI and stroke minutes count and therefore the fast track concept has been introduced. Time to treatment still appears to be longer in stroke than in AMI. In the future improvement in the early detection as well as further shortening to start of treatment will be in focus in both conditions. A collaboration between cardiologists and neurologists and also between pre-hospital and in-hospital care might be fruitful.

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“…However, these efforts are weakened by patient delay, which is said to account for almost two thirds of the time from the onset of symptoms to treatment. Many reports have shown that various factors such as age [15], gender [16], pre-infarction angina [17], and cognitive and emotional factors including the patient's beliefs about causes [18,19] were associated with patient delay. Our data suggest that factors such as advanced age, female sex, and DM are associated with patient delays.…”

Section: Discussionmentioning

confidence: 99%

Clinical manifestations and effects of primary percutaneous coronary intervention for patients with delayed pre-hospital time in acute myocardial infarction

Nomura

Tatsumi

Sawada

et al. 2010

Journal of Cardiology

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These findings indicate that patients with ET>12 h have a less severe condition and less frequently receive primary PCI compared with patients with ET≤12 h. Although primary PCI is often performed for these patients irrespective of the severity of heart failure, no preferable effect of primary PCI on the in-hospital mortality is demonstrated. In contrary, practice of primary PCI is a significant negative predictor of in-hospital mortality for patients with ET≤12 h.

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The association between pre-infarction angina and care-seeking behaviors and its effects on early reperfusion rates for acute myocardial infarction

Cited by 13 publications

References 41 publications

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Pre-Hospital Factors Influencing Time of Arrival at Emergency Departments for Patients with Acute ST-Elevation Myocardial Infarction

Early identification and delay to treatment in myocardial infarction and stroke: differences and similarities

Clinical manifestations and effects of primary percutaneous coronary intervention for patients with delayed pre-hospital time in acute myocardial infarction

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