Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction

Lee, Jae Hoon; Jeong, Myung Ho; Rhee, Jung Ae; Choi, Jin Su; Park, In Hyae; Chai, Leem Soon; Jang, Soo Yong; Cho, Jae Young; Jeong, Hae Chang; Lee, Ki Hong; Park, Keun-Ho; Sim, Doo Sun; Kim, Kye Hun; Hong, Young Joon; Park, Hyung Wook; Kim, Ju Han; Ahn, Young keun; Cho, Jeong Gwan; Park, Jong Chun

doi:2014.87.4.429

Korean J Med > Volume 87(4); 2014 > Article

Original Article

The Korean Journal of Medicine 2014;87(4):429-438.
Published online October 1, 2014.
DOI: https://doi.org/10.3904/kjm.2014.87.4.429

Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction

Jae Hoon Lee^1,2, Myung Ho Jeong^1,2, Jung Ae Rhee³, Jin Su Choi³, In Hyae Park⁴, Leem Soon Chai⁵, Soo Yong Jang^1,2, Jae Young Cho^1,2, Hae Chang Jeong^1,2, Ki Hong Lee^1,2, Keun-Ho Park^1,2, Doo Sun Sim^1,2, Kye Hun Kim^1,2, Young Joon Hong^1,2, Hyung Wook Park^1,2, Ju Han Kim^1,2, Young keun Ahn^1,2, Jeong Gwan Cho^1,2, Jong Chun Park^1,2

¹The Heart Center of Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea
²The Heart Research Center Designated by Korea Ministry of Health and Welfare, Gwangju, Korea
³Department of Preventive Medicine, Chonnam National University Medical School, Gwangju, Korea
⁴Nursing Department of Chonnam National University, Gwangju, Korea
⁵Gwangju Christian College of Nursing, Gwangju, Korea

ST분절 상승 심근경색증 환자에서 증상 발생 후 응급센터 도착 시간 지연에 영향을 주는 요인

이재훈^1,2, 정명호^1,2, 이정애³, 최진수³, 박인혜⁴, 채임순⁵, 장수영^1,2, 조재영^1,2, 정해창^1,2, 이기홍^1,2, 박근호^1,2, 심두선^1,2, 김계훈^1,2, 홍영준^1,2, 박형욱^1,2, 김주한^1,2, 안영근^1,2, 조정관^1,2, 박종춘^1,2

^¹전남대학교병원 심장센터
^²보건복지부 지정 심장질환 특성화 연구센터
^³전남대학교 의과대학 예방의학교실
^⁴전남대학교 간호대학
^⁵광주기독 간호대학

Correspondence:
Myung Ho Jeong, Tel: +82-62-220-6243, Fax: +82-62-228-7174, Email: myungho@chollian.net, mhjeong@chonnam.ac.kr

Received: 7 October 2013 • Revised: 27 December 2013 • Accepted: 3 May 2014

This is an Open Access article distributed under the terms of the Creative Commons Attribution NonCommercial License (http://creativecommons.org/licenses/bync/3.0/) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background/Aims: Delay in symptom-to-door time (SDT) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the most important factor in the prediction of short and long-term mortality. The purpose of this study was to investigate the social and clinical factors affecting SDT in patients with STEMI. Methods: We analyzed 784 patients (61.0 ± 13.2 years, 603 male) diagnosed with STEMI from November 2005 to February 2012. The patients were divided into four groups according to SDT: Group I (n = 163, ≤ 1 h), Group II (n = 183, 1-2 h), Group III (n = 142, 2-3 h) and Group IV (n = 296, > 3 h). Results: Delay in SDT increased with age (Group I, 58.4 ± 12.0; Group II, 59.4 ± 13.3; Group III, 62.0 ± 12.8; Group IV, 63.0 ± 13.8 years, p = 0.001). In 119 patients, transportation was less frequently used as the delay in SDT (41.7% vs. 29.0% vs. 26.1% vs. 9.8%, p < 0.001). By multiple logistic regression analysis, family history [OR, 0.488; CI, 0.248-0.959; p = 0.037], previous ischemic heart disease [OR, 0.572; CI, 0.331-0.989; p = 0.045], no occupation [OR, 1.600; CI, 1.076-2.380; p = 0.020] and method of transportation [OR, 0.353; CI, 0.239-0.520; p < 0.001] were independent predictors of delay in SDT. Conclusions: Our study shows that general education about cardiovascular symptoms and a prompt emergency call could be important to reduce SDT in STEMI.

Key Words: Myocardial infarction; Symptom to balloon time; Mortality

주제어: 심근경색; 일차적 관동맥 중재술 시간; 사망률