title: Impact of prodromal symptoms on prehospital delay in patients with first-time acute myocardial infarction in Korea.
abstract: BACKGROUND
  Information is limited concerning how affected individuals respond to early warning signs before their acute coronary event and how the presence of prodromal symptoms impacts prehospital delay.
  
  
  OBJECTIVE
  This study's aim was to identify the characteristics and interpretation of prodromal symptoms in patients with a first-time acute myocardial infarction (AMI) and to determine whether the presence of prodromal symptoms was predictive of prehospital delay.
  
  
  METHODS
  This was a descriptive study using semistructured interview. A total of 271 hospitalized patients diagnosed as having AMI were interviewed from November 2007 to December 2008 at a university hospital in Korea. Patients were queried regarding whether they noticed a most troubling prodromal symptom prior to their acute cardiac event and how they responded to the symptom.
  
  
  RESULTS
  Men (53.0%) and women (54.2%) experienced prodromal symptoms. Patients who reported prodromal symptoms were more likely to be older and to have no chest pain upon hospitalization than those with no prodromes. Many patients did not generally recognize the importance of their warning symptoms; only about 40% visited a clinic in response to any prodromal symptom. Logistic regression analyses revealed that the presence of prodromal symptoms was an independent predictor affecting prehospital delay of more than 3 hours and more than 12 hours.
  
  
  CONCLUSIONS
  Recognizing prodromal symptoms as needing attention could be a trigger for patients to seek medical help earlier. Educational strategies should focus on improving awareness of prodromal symptoms of AMI, particularly in those with a family history or at high risk for cardiovascular disease.
authors.affiliation: Department of Nursing, College of Medicine, Chosun University, Gwangju, South Korea. seon9772@chosun.ac.kr
authors.forename: Seon Young
authors.initials: SY
authors.lastname: Hwang
authors.forename: Julie J
authors.initials: JJ
authors.lastname: Zerwic
authors.forename: Myung Ho
authors.initials: MH
authors.lastname: Jeong
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D059026:Diagnostic Self Evaluation; D004632:Emergency Medical Services / Q000706:statistics & numerical data*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009203:Myocardial Infarction / Q000175:diagnosis* / Q000628:therapy; D010342:Patient Acceptance of Health Care; D010353:Patient Education as Topic; D056910:Republic of Korea; D012307:Risk Factors; D013997:Time Factors