Acute coronary syndrome, profile of latecomers in the region of Blida (Algeria) and the implication of the medical staff

Abstract

Acute coronary syndrome (ACS) management responds to the imperatives of time, this is articulated around clear deadlines whose reduction is a challenge of which will depend the prognosis, we aimed by this work to evaluate ACS management and its delays in the region of blida and its surroundings. We conducted a prospective, descriptive, single-center study of 222 patients admitted to the cardiovascular intensive care unit of Blida University hospital for the management of ACS over a four-month period (10/2018–02//2019). We mainly studied the delays and factors involved in their lengthening before and after appearance of the pathology. 76% of our patients were males (sex ratio 3.1), 47% were hypertensive, 39% were diabetic and 38% were smokers. Nearly 55% live in Blida, the rest came frome farther (50 to 450 km). 43% were hospitalized for STEMI and 57% NSTEMI. The average time for reperfusion (chest pain-reperfusion) was at 1536 min in NSTEMI while 58% of patients received for STEMI were reperfused within 6 hours. The average system delay (1st medical contact-reperfusion) was at 314 minutes for STEMI and 890 minutes for NSTEMI. Only 18% of the patients came directly to our level, 82% were viewed at least by one other center (non-capable of primary PCI or thrombolysis). An under equipated ambulance (45%) and the private vehicle (38%) were the main means of transport, only 01% of patients were transfered by medical emergency transport (SAMU). despite 52% of previous follow-ups in medical consultations, only 15% of the patients had a good knowledge of their cardiovascular pathology and only 18% were sensibilized to the risk of occurrence of ACS. We have relatively long delays in ACS management in our region, this work identify certain factors affecting directly this delay; in addition to a poorly organized network, there is a real inertia in the sensiblization of these patients despite their previous follow in consultation.