Delay in seeking medical care after symptom onset in patients with an acute myocardial
infarction (AMI) is related to increased morbidity and mortality. Duration of prehospital
delay in patients hospitalized with AMI has not been well characterized over time,
and potentially changing patient characteristics associated with prolonged delay are
not well understood. The study sample consisted of 5,967 residents (mean age 76 years;
39% women) of the Worcester, Massachusetts, metropolitan area hospitalized with AMI
in 11 annual periods from 1986 to 2005. Mean and median delay times have remained
essentially unchanged during the past 2 decades. Mean and median prehospital delay
times were 4.1 and 2.0 hours in 1986, 4.7 and 2.2 hours in 1995, and 4.6 and 2.0 hours
in 2005, respectively. Approximately 45% of patients with AMI presented within 2 hours
of acute symptom onset, whereas an additional one third presented from 2 to 6 hours
after the onset of acute coronary symptoms. Advancing age and history of either diabetes
or MI were associated with prolonged delay. Compared with patients arriving within
2 hours of symptom onset, those with prolonged prehospital delay were less likely
to receive thrombolytic therapy and percutaneous coronary intervention within 90 minutes
of hospital arrival. In conclusion, results of this population-based study suggest
that a large proportion of patients with AMI continue to show prolonged prehospital
delay.
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Article Info
Publication History
Published online: November 03, 2008
Accepted:
July 25,
2008
Received in revised form:
July 25,
2008
Received:
June 4,
2008
Footnotes
This work was supported by Grant RO1 HL35434 from the National Institutes of Health, Bethesda, Maryland.
Identification
Copyright
© 2008 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
