Factors Associated With Delays in Seeking Medical Attention in Patients With ST segment Elevation Acute Coronary Syndrome.
INTRODUCTION AND OBJECTIVES Prompt coronary reperfusion is crucial in patients with ST segment elevation acute coronary syndrome. The aim of this study was to determine factors associated with a delay in seeking medical attention after the onset of symptoms in patients with this condition. METHODS Prospective cohort study in consecutive patients with ST segment elevation infarction. Multiple logistic regression analysis was used to identify factors independently associated with a longer delay in requesting medical help. RESULTS In total, 444 consecutive patients were included (mean age, 63 years; 76% men, 20% with diabetes) Median total ischemia time was 225 (160 317) minutes; median delay in seeking medical attention was 110 (51 190) minutes. Older patients (age 75 years; odds ratio 11.6) women (odds ratio 3.4) individuals with diabetes (odds ratio 2.3) and those requesting medical care from home (odds ratio 2.2) showed the longest delays in seeking medical attention. Lengthy delay was associated with higher in hospital mortality (9.8% vs 2.7% P<.005) and 1 year mortality (7.3% vs 2.9% P<.05) than when attention was promptly solicited. CONCLUSIONS Elderly patients, women, and diabetic individuals with ST segment elevation myocardial infarction show longer delays in seeking medical attention for their condition. Delays in seeking medical attention are associated with greater in hospital and 1 year mortality.
Revista espanola de cardiologia