Patient and system delays in the treatment of acute coronary syndrome

• Type: Article in National Scientific Journal
• Date: 2020

Authors

Viana, M (Author) Other; Laszczynska, O (Author) Other; Araujo, C (Author) Other; Borges, A (Author) Other; Barros, V (Author) Other; Ribeiro, AI (Author) Other; Dias, P (Author) Other; Maciel MJ (Author) FMUP; Moreira, I (Author) Other; Lunet N (Author) FMUP; Azevedo A (Author) FMUP

Indexing

ISI Web of Knowledge - 7 Citations

Scopus - 9 Citations

Other information

Authenticus ID: P-00S-9BP

DOI: 10.1016/j.repc.2019.07.007

Abstract (EN): Introduction: Early reperfusion for patients with ST-segment elevation myocardial infarction (STEMI) is indicated by the European Society of Cardiology, while a timely invasive strategy is recommended for patients with high-risk and intermediate-risk non-ST-elevation acute coronary syndromes (NSTE-ACS). This study aims to assess patient and system delays according to diagnosis and risk profile, and to identify predictors of prolonged delay. Methods: We assembled a cohort of patients (n=939) consecutively admitted to the cardiology department of two hospitals, one in the metropolitan area of Porto and one in the north-east region of Portugal, between August 2013 and December 2014. Results: The proportion of patients with time from symptom onset to first medical contact (FMC) >= 120 min was highest among high-risk NSTE-ACS (57.7%), followed by intermediate-risk NSTE-ACS (52.1%) and STEMI (43.3%). Regardless of diagnosis and risk stratification, use of own transportation and inability to interpret cardiac symptoms correctly were associated with prolonged delays. Regarding system delays, we found that 78.0% of patients with STEMI and 65.8% of patients with high-risk NSTE-ACS were treated in a timeframe exceeding the recommended limits. Admission to a non-percutaneous coronary intervention-capable hospital, admission on weekends and complications at admission were associated with prolonged delays to treatment. Conclusions: Due to both patient and system delays, a large proportion of STEMI and high-risk NSTE-ACS patients still fail to have access to timely reperfusion. (C) 2020 Sociedade Portuguesa de Cardiologia. Published by Elsevier Espana, S.L.U.

Language: English

Type (Professor's evaluation): Scientific

No. of pages: 9