Please use this identifier to cite or link to this item:
Author(s): Viana, M
Laszczyńska, O
Araújo, C
Borges, A
Barros, V
Ribeiro, AI
Dias, P
Maciel, MJ
Moreira, I
Lunet, N
Azevedo, A
Title: Patient and system delays in the treatment of acute coronary syndrome
Publisher: Elsevier
Issue Date: 2020
Abstract: Introduction Early reperfusion for patients with ST-segment elevation myocardial infarction (STEMI) is indicated by the European Society of Cardiology, while a timely invasive strategy is recommended for patients with high-risk and intermediate-risk non-ST-elevation acute coronary syndromes (NSTE-ACS). This study aims to assess patient and system delays according to diagnosis and risk profile, and to identify predictors of prolonged delay. Methods We assembled a cohort of patients (n=939) consecutively admitted to the cardiology department of two hospitals, one in the metropolitan area of Porto and one in the north-east region of Portugal, between August 2013 and December 2014. Results The proportion of patients with time from symptom onset to first medical contact (FMC) ≥120 min was highest among high-risk NSTE-ACS (57.7%), followed by intermediate-risk NSTE-ACS (52.1%) and STEMI (43.3%). Regardless of diagnosis and risk stratification, use of own transportation and inability to interpret cardiac symptoms correctly were associated with prolonged delays. Regarding system delays, we found that 78.0% of patients with STEMI and 65.8% of patients with high-risk NSTE-ACS were treated in a timeframe exceeding the recommended limits. Admission to a non-percutaneous coronary intervention-capable hospital, admission on weekends and complications at admission were associated with prolonged delays to treatment. Conclusions Due to both patient and system delays, a large proportion of STEMI and high-risk NSTE-ACS patients still fail to have access to timely reperfusion.
Subject: Acute coronary syndrome
ST-segment elevation myocardial infarction
Non-ST-elevation acute coronary syndromes
Patient delays
System delays
Source: Rev Port Cardiol (Engl Ed). 2020 Mar;39(3):123-131
Related Information: info:eu-repo/grantAgreement/FCT/6817 - DCRRNI ID/UID/DTP/04750/2013/PT
Document Type: Artigo em Revista Científica Nacional
Rights: openAccess
Appears in Collections:ISPUP - Artigo em Revista Científica Nacional

Files in This Item:
File Description SizeFormat 
viana-rpc-2020.pdf890.49 kBAdobe PDFThumbnail

This item is licensed under a Creative Commons License Creative Commons