Document Detail


The association between pre-infarction angina and care-seeking behaviors and its effects on early reperfusion rates for acute myocardial infarction.
MedLine Citation:
PMID:  18845348     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: To examine the association between pre-infarction angina (PA) and care-seeking behaviors and its effects on early reperfusion rates for patients with ST-elevation myocardial infarction (STEMI). METHODS: Between November 1, 2005 and December 31, 2006, a prospective, cross-sectional, and multicenter survey was conducted in 19 hospitals in Beijing and included consecutive patients with STEMI admitted within 12 h of onset of symptoms. Data were collected by structured interviews and medical records review. RESULTS: PA within 48 h prior to the onset of the infarction occurred in 50.4% of the 498 patients. Prior to seeking care, patients in the PA group more frequently thought the symptoms would go away (61.8% vs. 38.5%, p < 0.001) and attempted some form of self-treatment (61.0% vs. 45.3%, p = 0.001) than the patients without PA (non-PA group). Median pre-hospital delay in the PA group was longer (118 vs. 103 min, p = 0.045) than in the non-PA group. The prevalence of ambulance use in the PA group was significantly lower than in the non-PA group (31.5% vs. 43.3%, p = 0.007). Multivariate analysis showed that the presence of PA was an independent predictor of pre-hospital delay >2 h (OR 1.863, 95% CI: 1.112-2.765, p = 0.013) and non-ambulance use (OR 1.724, 95% CI: 1.185-2.670, p = 0.003). In addition, patients in the PA group had a lower early reperfusion rate (74.7% vs. 83.3%, p = 0.027), mainly because of a lower incidence of primary percutaneous coronary intervention (58.6% vs. 67.9%, p = 0.042). CONCLUSIONS: Presence of PA was associated with longer pre-hospital delay, significantly decreased use of ambulance, and lower early reperfusion rates among patients with STEMI.
Authors:
Hongbing Yan; Li Song; Jingang Yang; Yihong Sun; Dayi Hu
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Publication Detail:
Type:  Journal Article; Multicenter Study; Research Support, Non-U.S. Gov't     Date:  2008-10-08
Journal Detail:
Title:  International journal of cardiology     Volume:  135     ISSN:  1874-1754     ISO Abbreviation:  Int. J. Cardiol.     Publication Date:  2009 Jun 
Date Detail:
Created Date:  2009-06-02     Completed Date:  2009-08-19     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8200291     Medline TA:  Int J Cardiol     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  86-92     Citation Subset:  IM    
Affiliation:
The 28th Division, Beijing Anzhen Hospital of the Capital University of Medical Science, Beijing, China.
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MeSH Terms
Descriptor/Qualifier:
Aged
Ambulances / statistics & numerical data
Angina Pectoris / epidemiology*,  therapy*
China / epidemiology
Cross-Sectional Studies
Decision Making
Emergency Medical Services / statistics & numerical data
Female
Humans
Logistic Models
Male
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology*,  prevention & control*
Myocardial Reperfusion / statistics & numerical data*
Patient Acceptance of Health Care / statistics & numerical data*
Prevalence
Prospective Studies
Time Factors
Urban Population / statistics & numerical data

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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