Patient and system delays in the treatment of acute coronary syndrome

• Tipo: Artigo em Revista Científica Nacional
• Data: 2020

Autores

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

Indexação

ISI Web of Knowledge - 7 Citações

Scopus - 9 Citações

Outras Informações

ID Authenticus: 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.

Idioma: Inglês

Tipo (Avaliação Docente): Científica

Nº de páginas: 9