Delays in thrombolytic therapy for acute myocardial infarction: association with mode of transportation to the hospital, age, sex, and race.
BACKGROUND
Although increased myocardial salvage and reduced mortality are associated with timely thrombolytic therapy for acute myocardial infarction, some patients still experience delays in treatment.


OBJECTIVE
To examine treatment times in patients with acute myocardial infarction treated with thrombolytic therapy and to determine whether delays in treatment are associated with mode of transportation to the hospital, age, sex, or race.


METHODS
Medical records of 176 patients with acute myocardial infarction treated with thrombolytic therapy at a community hospital were reviewed and analyzed retrospectively.


RESULTS
Median times for the interval between arrival at the hospital and acquisition of a diagnostic electrocardiogram (door-to-electrocardiography time) and the interval between arrival and start of thrombolytic therapy (door-to-drug time) were 6 minutes and 34 minutes, respectively. However, 76.1% of the patients met the recommendation of the American College of Cardiology/American Heart Association of door-to-electrocardiography time of 10 minutes, and 47.2% met the recommendation of door-to-drug time of 30 minutes or less. Door-to-drug times did not differ significantly according to race or mode of transportation to the hospital. Door-to-electrocardiography and electrocardiography-to-drug times were significantly longer for older patients than for younger patients (P = .005 and P < .001, respectively), and electrocardiography-to-drug times were significantly longer for females than for males (P = .01).


CONCLUSIONS
With increased emphasis on recognition and rapid treatment of patients with acute myocardial infarction at highest risk for delays in treatment, that is, women and the elderly, benefits of thrombolytic therapy might be maximized.
Davis
L L
LL
University of North Carolina at Chapel Hill, School of Nursing, Chapel Hill, NC, USA.
Evans
J J
JJ
Strickland
J D
JD
Shaw
L K
LK
Wagner
G S
GS
D000367:Age Factors; D000368:Aged; D015986:Confounding Factors, Epidemiologic; D005006:Ethnicity / Q000706:statistics & numerical data; D005260:Female; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000188:drug therapy* / Q000208:ethnology; D009657:North Carolina; D012737:Sex Factors; D015912:Thrombolytic Therapy / Q000706:statistics & numerical data*; D013997:Time Factors; D014187:Transportation of Patients / Q000379:methods*