Prehospital period in patients with myocardial infarction in Turkey

OBJECTIVE: To identify the causes that affect the time from the onset of symptoms to admission to the hospital, in patients with a diagnosis of acute myocardial infarction (MI).

METHODS: The study was carried out between January 2004 and January 2005 in the Emergency Room of the Uludag University Faculty of Medicine (UUFM) Hospital, Turkey. A total of 180 patients were included. Residents of the UUFM Department of Cardiology distributed a questionnaire to all patients. Socioeconomic level was determined by scoring the socioeconomic factors. For statistical analyses we used the SPSS 13.0 statistical software.

RESULTS: Of the 180 patients, 79.4% (n=143) were admitted to the hospital within 6 hours of onset of symptoms and 20.6% (n=37) the time exceeded 6 hours of which 10% (n=18) admitted in more than 12 hours. Male patients seemed to present earlier than females (p<0.05 and p<0.05). The time to admission decreased as the socioeconomic level improved and the level of education increased. Patients with a history of MI, who had coronary angioplasty and had undergone coronary by-pass surgery admitted to the hospital earlier than those who did not have these factors p=0.042, p=0.005, p=0.026. Subjects who had anginal symptoms prior to acute MI (p<0.001) and patients with diabetes (p<0.001) had a significantly longer admission time.

CONCLUSION: It is essential to inform individuals with a low level of education and socioeconomic status; patients with anginal complaints and diabetic persons; particularly females, on the symptoms of MI and the importance of early hospitalization on the outcome.