PMID- 27540516
OWN - NLM
STAT- PubMed-not-MEDLINE
DCOM- 20160819
LR  - 20200930
IS  - 0253-8253 (Print)
IS  - 2227-0426 (Electronic)
IS  - 0253-8253 (Linking)
VI  - 2016
IP  - 1
DP  - 2016
TI  - Predictors of delayed pre-hospital presentation among patients with ST-segment 
      elevation myocardial infarction.
PG  - 7
LID - 10.5339/qmj.2016.7 [doi]
LID - 7
AB  - BACKGROUND: Early treatment of ST elevation myocardial infarction (STEMI) is 
      essential to improve survival of these patients. However, not all patients 
      present early enough to receive optimal treatment especially in third world 
      countries. Social factors affecting early vs. late treatment have not been 
      studied, particularly in the Middle East. Thus, the aim of this study was to 
      determine the social factors associated with delayed presentation of STEMI 
      patients. METHODS: All patients with STEMI presenting to King Abdulaziz Cardiac 
      Center (KACC) between October 2013 and July 2014 were approached. After obtaining 
      consent, patients were interviewed regarding their psychosocial circumstances 
      using a standardized questionnaire. Their medical charts were also reviewed for 
      further clinical data. Patients were divided according to their symptom-to-door 
      time into early ( </= 6h) and late (>6h) presentation and group comparisons were 
      conducted. RESULTS: A total of 79 patients were enrolled, of which 24 patients 
      (30%) presented late. Patients with increased symptom-to-door time had higher 
      prevalence of diabetes (40% vs. 79.2%, p = 0.001), hypertension (43.6% vs. 70.8%, 
      p = 0.023), and dyslipidemia (23.6% vs. 54.2%, p = 0.009). Most of the late 
      presenters did not undergo primary coronary intervention (72.7% vs. 47.8%, 
      P = 0.034) and had less prior information about myocardial infarction (43.6% vs. 
      25%, P = 0.023). Late presenters were more often illiterates and lived most often 
      far away from the hospital. Using multivariate logistic regression; dyslipidemia 
      was the only independent predictor for the late hospital presentation for STEMI 
      patients. CONCLUSION: One third of patients with STEMI present more than six 
      hours after symptom onset; these patients have a higher prevalence of coronary 
      risk factors and less information about STEMI. Programs should be designed to 
      educate patients and the general public about the symptoms of STEMI and the 
      necessary action to be taken if a heart attack is suspected.
FAU - Albrahim, Mohammed
AU  - Albrahim M
AD  - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
FAU - Ahmed, Amjad M
AU  - Ahmed AM
AD  - King Abdulaziz Cardiac Center, Ministry of National Guard - Health Affairs, 
      Riyadh, Saudi Arabia.
FAU - Alwakeel, Abdulrahman
AU  - Alwakeel A
AD  - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
FAU - Hijji, Faisal
AU  - Hijji F
AD  - King Saud bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia.
FAU - Al-Mallah, Mouaz H
AU  - Al-Mallah MH
LA  - eng
PT  - Journal Article
DEP - 20160726
PL  - Qatar
TA  - Qatar Med J
JT  - Qatar medical journal
JID - 8101648
PMC - PMC4974464
OTO - NOTNLM
OT  - STEMI
OT  - late presentation myocardial infarction; third world countries
OT  - social factors
EDAT- 2016/08/20 06:00
MHDA- 2016/08/20 06:01
PMCR- 2016/07/26
CRDT- 2016/08/20 06:00
PHST- 2015/12/28 00:00 [received]
PHST- 2016/05/22 00:00 [accepted]
PHST- 2016/08/20 06:00 [entrez]
PHST- 2016/08/20 06:00 [pubmed]
PHST- 2016/08/20 06:01 [medline]
PHST- 2016/07/26 00:00 [pmc-release]
AID - qmj.2016.7 [pii]
AID - 10.5339/qmj.2016.7 [doi]
PST - epublish
SO  - Qatar Med J. 2016 Jul 26;2016(1):7. doi: 10.5339/qmj.2016.7. eCollection 2016.