title: Factors Associated With Delays in Seeking Medical Attention in Patients With ST-segment Elevation Acute Coronary Syndrome.
abstract: OBJECTIVE
  Prompt coronary reperfusion is crucial in patients with ST-segment elevation acute coronary syndrome. The aim of this study was to determine factors associated with a delay in seeking medical attention after the onset of symptoms in patients with this condition.
  
  
  METHODS
  Prospective cohort study in consecutive patients with ST segment elevation infarction. Multiple logistic regression analysis was used to identify factors independently associated with a longer delay in requesting medical help.
  
  
  RESULTS
  In total, 444 consecutive patients were included (mean age, 63 years; 76% men, 20% with diabetes). Median total ischemia time was 225 (160-317) minutes; median delay in seeking medical attention was 110 (51-190) minutes. Older patients (age > 75 years; odds ratio = 11.6), women (odds ratio = 3.4), individuals with diabetes (odds ratio = 2.3), and those requesting medical care from home (odds ratio = 2.2) showed the longest delays in seeking medical attention. Lengthy delay was associated with higher in-hospital mortality (9.8% vs 2.7%; P<.005) and 1-year mortality (7.3% vs 2.9%; P<.05) than when attention was promptly solicited.
  
  
  CONCLUSIONS
  Elderly patients, women, and diabetic individuals with ST-segment elevation myocardial infarction show longer delays in seeking medical attention for their condition. Delays in seeking medical attention are associated with greater in-hospital and 1-year mortality.
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Fernando
authors.initials: F
authors.lastname: Rivero
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Teresa
authors.initials: T
authors.lastname: Bastante
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Javier
authors.initials: J
authors.lastname: Cuesta
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Amparo
authors.initials: A
authors.lastname: Benedicto
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Jorge
authors.initials: J
authors.lastname: Salamanca
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Jorge-Andrés
authors.initials: JA
authors.lastname: Restrepo
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
authors.forename: Río
authors.initials: R
authors.lastname: Aguilar
authors.affiliation: Servicio de Cuidados Intensivos, Hospital Universitario del Henares, Coslada, Madrid, Spain.
authors.forename: Federico
authors.initials: F
authors.lastname: Gordo
authors.affiliation: Servicio de Cardiología, Hospital Universitario del Henares, Coslada, Madrid, Spain.
authors.forename: Maurice
authors.initials: M
authors.lastname: Batlle
authors.affiliation: Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain. Electronic address: falf@hotmail.com.
authors.forename: Fernando
authors.initials: F
authors.lastname: Alfonso
mesh_terms: D054058:Acute Coronary Syndrome / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D015331:Cohort Studies; D015897:Comorbidity; D003920:Diabetes Mellitus / Q000453:epidemiology; D005260:Female; D017052:Hospital Mortality; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D015425:Myocardial Reperfusion; D016017:Odds Ratio; D010342:Patient Acceptance of Health Care / Q000706:statistics & numerical data*; D011446:Prospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis* / Q000453:epidemiology / Q000628:therapy; D012737:Sex Factors; D012907:Smoking / Q000453:epidemiology; D013030:Spain / Q000453:epidemiology; D013318:Stroke Volume; D013997:Time Factors; D061665:Time-to-Treatment
keywords: Epidemiology; Epidemiología; Infarto de miocardio; Intervencionismo coronario primario; Myocardial infarction; Primary coronary intervention; Reperfusion; Reperfusion times; Reperfusión; Tiempos de reperfusión