Document Detail


Impact of a nationwide public campaign on delays and outcome in Swiss patients with acute coronary syndrome.
MedLine Citation:
PMID:  21450676     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Background: To improve the outcome in patients with acute coronary syndrome (ACS), public campaigns have been launched aimed at shortening presentation delays and allowing more efficient treatment. Their impact is uncertain. Methods: Pre-hospital delays and outcome in patients with ACS included in the Swiss National AMIS Plus registry were assessed prospectively before and after a nationwide multimedia campaign ('HELP') by the Swiss Heart Foundation in 2007. The campaign aimed at better awareness of symptoms, increasing knowledge in laymen of resuscitation and more rapid access to medical services. The primary study endpoint was the time between onset of symptoms and hospital admission. Secondary endpoints were successful out-of-hospital resuscitation, symptoms upon admission, and outcome. Results: Between January 2005 and December 2008, 8906 ACS patients (61% ST-segment elevation myocardial infarction (STEMI), 39% non-ST-segment elevation myocardial infarction/unstable angina pectoris (NSTEMI/UAP), mean age 65 ± 13 years, 75% males) admitted within 24 hours after onset of symptoms were enrolled. The median pre-hospital delay was reduced from 197 minutes during the pre-intervention period to 180 minutes during the post-intervention period (reduction 10% (95% confidence interval (CI) 6-14%); P < 0.001), in STEMI (reduction 10% (95% CI 5-14%); P < 0.001) and NSTEMI patients (reduction 11% (95% CI 4-17%); P = 0.001), due to pronounced effects in males (reduction 12% (95% CI 7-16%); P < 0.001) and in patients ≤75 years (reduction 12% (95% CI 8-16%); P < 0.001). Out-of-hospital resuscitation increased (odds ratio (OR) 1.26 (95% CI 1.06-1.54); P = 0.02). Overall outcome remained unchanged, however, the rate of re-infarction showed a decrease (OR 0.58 (95% CI 0.36-0.91); P = 0.021). Conclusions: After a nationwide educational campaign, shorter pre-hospital delays were observed, and more patients were able to be treated promptly. These results may be useful in planning future health strategies to improve management and outcome of patients with ACS, especially in female and elderly patients.
Authors:
Barbara Naegeli; Dragana Radovanovic; Hans Rickli; Paul Erne; Burkhardt Seifert; Nicole Duvoisin; Giovanni Pedrazzini; Philip Urban; Osmund Bertel
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Publication Detail:
Type:  Journal Article     Date:  2011-02-11
Journal Detail:
Title:  European journal of cardiovascular prevention and rehabilitation : official journal of the European Society of Cardiology, Working Groups on Epidemiology & Prevention and Cardiac Rehabilitation and Exercise Physiology     Volume:  18     ISSN:  1741-8275     ISO Abbreviation:  Eur J Cardiovasc Prev Rehabil     Publication Date:  2011 Apr 
Date Detail:
Created Date:  2011-03-31     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101192000     Medline TA:  Eur J Cardiovasc Prev Rehabil     Country:  England    
Other Details:
Languages:  eng     Pagination:  297-304     Citation Subset:  IM    
Affiliation:
HerzGefässZentrum, Klinik Im Park, Zürich, Switzerland.
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