Revista Española de Cardiología (English Edition) Revista Española de Cardiología (English Edition)
Rev Esp Cardiol. 2016;69:279-85 - Vol. 69 Num.03 DOI: 10.1016/j.rec.2015.07.029

Factors Associated With Delays in Seeking Medical Attention in Patients With ST-segment Elevation Acute Coronary Syndrome

Fernando Rivero a, Teresa Bastante a, Javier Cuesta a, Amparo Benedicto a, Jorge Salamanca a, Jorge-Andrés Restrepo a, Río Aguilar a, Federico Gordo b, Maurice Batlle c, Fernando Alfonso a,

a Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
b Servicio de Cuidados Intensivos, Hospital Universitario del Henares, Coslada, Madrid, Spain
c Servicio de Cardiología, Hospital Universitario del Henares, Coslada, Madrid, Spain

Refers to

Health Promotion to Reduce Delays in Seeking Medical Attention in Patients With Acute Coronary Syndrome
Francisco L. Moreno-Martínez, Elibet Chávez-González, María T. Moreno-Valdés, Ricardo Oroz Moreno
Rev Esp Cardiol. 2016;69:713
Full text - PDF

Keywords

Myocardial infarction. Epidemiology. Reperfusion. Primary coronary intervention. Reperfusion times.

Abstract

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.

1885-5857/© 2016 Sociedad Española de Cardiología. Published by Elsevier España, S.L.U. All rights reserved

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