Korean J Med.
2014 Oct;87(4):429-438. 10.3904/kjm.2014.87.4.429.
Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction
- Affiliations
-
- 1The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea. myungho@chollian.net
- 2The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea.
- 3Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea.
- 4Nursing Department of Chonnam National University, Gwangju, Korea.
- 5Gwangju Christian College of Nursing, Gwangju, Korea.
- KMID: 2269218
- DOI: http://doi.org/10.3904/kjm.2014.87.4.429
Abstract
- BACKGROUND/AIMS
Delay in symptom-to-door time (SDT) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the most important factor in the prediction of short and long-term mortality. The purpose of this study was to investigate the social and clinical factors affecting SDT in patients with STEMI.
METHODS
We analyzed 784 patients (61.0 +/- 13.2 years, 603 male) diagnosed with STEMI from November 2005 to February 2012. The patients were divided into four groups according to SDT: Group I (n = 163, < or = 1 h), Group II (n = 183, 1-2 h), Group III (n = 142, 2-3 h) and Group IV (n = 296, > 3 h).
RESULTS
Delay in SDT increased with age (Group I, 58.4 +/- 12.0; Group II, 59.4 +/- 13.3; Group III, 62.0 +/- 12.8; Group IV, 63.0 +/- 13.8 years, p = 0.001). In 119 patients, transportation was less frequently used as the delay in SDT (41.7% vs. 29.0% vs. 26.1% vs. 9.8%, p < 0.001). By multiple logistic regression analysis, family history [OR, 0.488; CI, 0.248-0.959; p = 0.037], previous ischemic heart disease [OR, 0.572; CI, 0.331-0.989; p = 0.045], no occupation [OR, 1.600; CI, 1.076-2.380; p = 0.020] and method of transportation [OR, 0.353; CI, 0.239-0.520; p < 0.001] were independent predictors of delay in SDT.
CONCLUSIONS
Our study shows that general education about cardiovascular symptoms and a prompt emergency call could be important to reduce SDT in STEMI.
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