Components and determinants of therapeutic delay in patients with acute ST-elevation myocardial infarction : A tertiary care hospital-based study

BACKGROUND: Delayed reperfusion is associated with worse outcomes in ST-segment elevation myocardial infarction (STEMI). This study was conducted to assess the components and determinants of therapeutic delay in STEMI patients of our state

Bibliographische Detailangaben
Veröffentlicht in:Journal of the Saudi Heart Association. - 1999. - 29(2017), 1 vom: 14. Jan., Seite 7-14
1. Verfasser: Beig, Jahangir Rashid (VerfasserIn)
Weitere Verfasser: Tramboo, Nisar A, Kumar, Kuldeep, Yaqoob, Irfan, Hafeez, Imran, Rather, Fayaz A, Shah, Tariq R, Rather, Hilal A
Format: Online-Aufsatz
Sprache:English
Veröffentlicht: 2017
Zugriff auf das übergeordnete Werk:Journal of the Saudi Heart Association
Schlagworte:Journal Article Coronary artery disease Late presentation Prehospital delay ST-elevation myocardial infarction Treatment delay
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520 |a BACKGROUND: Delayed reperfusion is associated with worse outcomes in ST-segment elevation myocardial infarction (STEMI). This study was conducted to assess the components and determinants of therapeutic delay in STEMI patients of our state 
520 |a METHODS: This study included consecutive patients of STEMI admitted to the coronary care units of two tertiary care hospitals in Srinagar, between 2012 and 2015. Various components of treatment delay including the patient's decision to delay, referral delay, transportation delay, prehospital delay, and door-to-needle time were calculated. Factors associated with delayed treatment and clinico-demographic correlates of late presentation were identified 
520 |a RESULTS: During a period of 3 years, 523 patients (mean age, 57.6 ± 10.5 years) were enrolled in this study. Thrombolysis was administered to 60.2% patients, while 39.8% of patients could not be thrombolysed because of late presentation. The median treatment delay was 250 minutes. Prehospital delay constituted about 83.8% of total treatment delay. Patient's decision to delay, referral delay, and transport delay constituted 59%, 16%, and 25% of prehospital delay, respectively. Median door-to-needle time was 40 minutes. Residence in rural areas [odds ratio (OR), 2.35; 95% confidence interval (CI), 1.60-3.46], absence of prior coronary artery disease (OR, 1.54; 95% CI, 1.00-2.39), and negative family history of coronary artery disease (OR; 2.76; 95% CI, 1.86-4.10), were identified as independent predictors of delayed presentation (p < 0.001). Interestingly, 44.7% of the patients presented late due to misdiagnosis by local healthcare providers 
520 |a CONCLUSION: The standard of STEMI management in our state is far from ideal, and calls for a lot of improvement. Major efforts to reduce prehospital and in-hospital treatment delays are urgently needed 
650 4 |a Journal Article 
650 4 |a Coronary artery disease 
650 4 |a Late presentation 
650 4 |a Prehospital delay 
650 4 |a ST-elevation myocardial infarction 
650 4 |a Treatment delay 
700 1 |a Tramboo, Nisar A  |e verfasserin  |4 aut 
700 1 |a Kumar, Kuldeep  |e verfasserin  |4 aut 
700 1 |a Yaqoob, Irfan  |e verfasserin  |4 aut 
700 1 |a Hafeez, Imran  |e verfasserin  |4 aut 
700 1 |a Rather, Fayaz A  |e verfasserin  |4 aut 
700 1 |a Shah, Tariq R  |e verfasserin  |4 aut 
700 1 |a Rather, Hilal A  |e verfasserin  |4 aut 
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