Prehospital period in patients with myocardial infarction in Turkey

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).

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.

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.

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.