title: Acute coronary syndrome: what do patients know?
abstract: BACKGROUND
  The effectiveness of therapy for an acute coronary syndrome (ACS) is dependent on patients' quick decision to seek treatment. We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease.
  
  
  METHODS
  Patients (N = 3522) had a mean age of 67 years, 68% were male, and all had a history of AMI or invasive cardiac procedure for ischemic heart disease. Data were gathered using a 26-item instrument focusing on ACS symptoms and appropriate steps to seeking treatment. Patients were asked to identify their level of perceived risk for a future AMI.
  
  
  RESULTS
  Forty-six percent of patients had low knowledge levels (ie, <70% of answers were correct). The mean score was 71%. Higher knowledge scores were significantly related to female sex (P = .001), younger age (P = .001), higher education (P = .001), participation in cardiac rehabilitation (P = .001), and receiving care by a cardiologist rather than an internist or general practitioner (P = .005). Clinical history (eg, AMI [P = .24] and cardiac surgery [P = .38]) were not significant predictors of knowledge. Most (57%) identified themselves as being at higher risk for a future AMI compared with an age-matched individual without heart disease with 1 exception. Namely, patients who had undergone coronary artery bypass surgery felt significantly less vulnerable for a future AMI than other individuals of the same age.
  
  
  CONCLUSIONS
  Even following diagnosis of ACS and numerous interactions with physicians and other health care professionals, knowledge about ACS symptoms and treatment on the part of patients with cardiac disease remains poor. Patients require continued reinforcement about the nature of cardiac symptoms, the benefits of early treatment, and their risk status.
authors.affiliation: School of Nursing, University of California, San Francisco, CA 94143, USA. Kathy.Dracup@nursing.ucsf.edu
authors.forename: Kathleen
authors.initials: K
authors.lastname: Dracup
authors.forename: Sharon
authors.initials: S
authors.lastname: McKinley
authors.forename: Lynn V
authors.initials: LV
authors.lastname: Doering
authors.forename: Barbara
authors.initials: B
authors.lastname: Riegel
authors.forename: Hendrika
authors.initials: H
authors.lastname: Meischke
authors.forename: Debra K
authors.initials: DK
authors.lastname: Moser
authors.forename: Michele
authors.initials: M
authors.lastname: Pelter
authors.forename: Beverly
authors.initials: B
authors.lastname: Carlson
authors.forename: Leanne
authors.initials: L
authors.lastname: Aitken
authors.forename: Andrea
authors.initials: A
authors.lastname: Marshall
authors.forename: Rebecca
authors.initials: R
authors.lastname: Cross
authors.forename: Steven M
authors.initials: SM
authors.lastname: Paul
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000628:therapy*; D000368:Aged; D005260:Female; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D008297:Male; D010353:Patient Education as Topic; D012307:Risk Factors