title: Patient education after acute myocardial infarction: cardiologists should adapt their message--French registry of acute ST-elevation or non-ST-elevation myocardial infarction 2010 registry.
abstract: OBJECTIVE
  A shorter time delay between onset of symptoms and first call for medical attention would be expected in patients with a history of ischemic heart disease (IHD). We aimed to determine whether time to first call for an ST-elevation myocardial infarction (STEMI) differed between patients with or without history of coronary artery disease from the French registry of acute ST-elevation or non-ST-elevation myocardial infarction (FAST-MI) 2010 registry.
  
  
  METHODS
  FAST-MI 2010 is a nationwide French registry that included 4169 patients with acute myocardial infarction (AMI, 2193 STEMI) at the end of 2010 in 213 centers. Factors correlated with time to first call were assessed, with a specific emphasis on previous history of IHD (IHD+; n = 402), compared with patients without history of IHD (IHD-; n = 1791).
  
  
  RESULTS
  Time from onset to first call was 222 ± 420 min (median time 68 min) in IHD+ patients versus 240 ± 4423 min (median time 75 min) in IHD- patients (P = 0.28). In multivariate analysis, only a few factors were significantly related to a shorter time from onset to first call (≤75min); time of onset during the day (7:00 a.m. to 11:00 p.m.), upper socioeconomic class, anterior MI, cardiac arrest as the initial symptom, whereas history of IHD was not associated with a shorter time delay (odds ratio 0.86; 95% confidence interval 0.70-1.05). Similar results were found between patients with previous AMI and IHD- patients.
  
  
  CONCLUSIONS
  Patients with a history of IHD do not call earlier than IHD-naïve patients when they are confronted with symptoms of AMI. Cardiologists should spend more time educating their coronary patients to recognize symptoms of AMI.Clinicaltrials.gov identifier: NCT01237418.
authors.affiliation: aAssistance Publique-Hôpitaux de Paris (AP-HP), Hôpital Européen Georges Pompidou, Department of Cardiology, Paris, Université Paris-Descartes bINSERM U-970 cAP-HP, Hôpital Saint Antoine, Department of Clinical Pharmacology and Unité de Recherche Clinique (URCEST) dUniversité Pierre et Marie Curie (UPMC-Paris 06) eAP-HP, Hôpital Bichat fParis, France, Université Paris-Diderot, Sorbonne Paris-Cité gINSERM U-698, Paris hUniversity Hospital Jean Minjoz, Department of Cardiology, Besançon iUniversity Hospital of Lille, Department of Cardiology, Lille jUniversity hospital of Nantes, Nantes kUniversity hospital of Nancy, Nancy lToulouse Rangueil University Hospital, Department of Cardiology, UMR1027, INSERM, Toulouse, France.
authors.forename: Etienne
authors.initials: E
authors.lastname: Puymirat
authors.forename: Nelson
authors.initials: N
authors.lastname: Teixeira
authors.forename: Tabassome
authors.initials: T
authors.lastname: Simon
authors.forename: Philippe G
authors.initials: PG
authors.lastname: Steg
authors.forename: François
authors.initials: F
authors.lastname: Schiele
authors.forename: Nicolas
authors.initials: N
authors.lastname: Lamblin
authors.forename: Vincent
authors.initials: V
authors.lastname: Probst
authors.forename: Yves
authors.initials: Y
authors.lastname: Juillière
authors.forename: Jean
authors.initials: J
authors.lastname: Ferrières
authors.forename: Nicolas
authors.initials: N
authors.lastname: Danchin
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003324:Coronary Artery Disease / Q000150:complications / Q000453:epidemiology; D005260:Female; D005602:France / Q000453:epidemiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D010343:Patient Admission / Q000706:statistics & numerical data; D010353:Patient Education as Topic / Q000379:methods*; D012042:Registries; D012923:Social Class