43. Predictors of delayed presentation among patients with STEMI (ST elevation myocardial infarction) in King Abdul-Aziz Cardiac Center, Riyadh, KSA

Abstract

Early treatment of ST elevation myocardial infarction (STEMI) is essential for the survival of these patients. Not all Saudi patients present early enough to receive optimal treatment. Thus, the aim of this study is to determine the social factors that are associated with delayed presentation of STEMI patients. All patients with STEMI presenting to King Abdul-Aziz Cardiac Center (KACC) from 10/2013 to 7/2014 were enrolled. After obtaining consent, patients were interviewed regarding their psychosocial circumstances using a questionnaire. Their medical charts were also reviewed for further clinical data. Patients were divided according to their symptom to door time into early (⩽6 h) and late (>6 h). Data comparison was done between them. A total of 79 patients were enrolled, of which 24 patients (30%) presented late. Patients with increased symptom to door time had higher prevalence of diabetes (40% vs. 79.2%, p = 0.001), hypertension (43.6% vs. 70.8%, p = 0.023), and dyslipidemia (23.6% vs. 54.2%, p = 0.009). Most of the late presenters did not undergo PCI (primary coronary intervention) (72.7% vs. 47.8%, p = 0.034) and had less background information about myocardial infarction (43.6% vs. 25%, p = 0.023). There was no significant difference between the two groups in other clinical and social variables. Almost 30% of our patients with STEMI presented more than six hours after symptom onset, these patients have high prevalence of coronary risk factors. Programs should be designed to educate these patients at risk about the symptoms of STEMI and the necessary action to be taken if a heart attack is suspected.