Acute coronary syndrome: what do patients know?
Kathleen Dracup1, Sharon McKinley, Lynn V Doering
1School of Nursing, University of California, San Francisco, CA 94143, USA. Kathy.Dracup@nursing.ucsf.edu
Insights
Patients with heart disease often have poor knowledge of acute coronary syndrome (ACS) symptoms and treatment. Continued education is crucial for improving patient understanding of cardiac symptoms and early intervention benefits.
Area of Science:
- Cardiology
- Public Health
- Patient Education
Background:
- Acute coronary syndrome (ACS) treatment effectiveness relies on prompt patient action.
- Patients with established ischemic heart disease often lack awareness of ACS symptoms and personal risk for acute myocardial infarction (AMI).
Purpose of the Study:
- To assess patient knowledge of ACS symptoms and their self-perceived risk for future AMI.
- To identify factors associated with knowledge levels regarding heart disease in patients with prior cardiac events.
Main Methods:
- A survey of 3522 patients (mean age 67, 68% male) with a history of AMI or cardiac procedures was conducted.
- A 26-item instrument assessed knowledge of ACS symptoms, treatment-seeking behavior, and perceived future AMI risk.
- Statistical analysis identified correlations between knowledge scores and demographic/clinical factors.
Main Results:
- 46% of patients demonstrated low knowledge (<70% correct answers), with a mean score of 71%.
- Higher knowledge was linked to female sex, younger age, higher education, cardiac rehabilitation, and cardiologist care.
- Past AMI or cardiac surgery did not predict knowledge levels, and many patients underestimated their future AMI risk, especially post-coronary artery bypass surgery.
Conclusions:
- Despite medical interventions, patient knowledge of ACS symptoms and timely treatment remains inadequate.
- Ongoing reinforcement of cardiac symptom recognition, early treatment advantages, and individual risk is essential for patients with heart disease.
Background:
The effectiveness of therapy for an acute coronary syndrome (ACS) is dependent on patients' quick decision to seek treatment. We surveyed patients' level of knowledge about heart disease and self-perceived risk for a future acute myocardial infarction (AMI) in patients with documented ischemic heart disease.
Methods:
Patients (N = 3522) had a mean age of 67 years, 68% were male, and all had a history of AMI or invasive cardiac procedure for ischemic heart disease. Data were gathered using a 26-item instrument focusing on ACS symptoms and appropriate steps to seeking treatment. Patients were asked to identify their level of perceived risk for a future AMI.
Results:
Forty-six percent of patients had low knowledge levels (ie, <70% of answers were correct). The mean score was 71%. Higher knowledge scores were significantly related to female sex (P = .001), younger age (P = .001), higher education (P = .001), participation in cardiac rehabilitation (P = .001), and receiving care by a cardiologist rather than an internist or general practitioner (P = .005). Clinical history (eg, AMI [P = .24] and cardiac surgery [P = .38]) were not significant predictors of knowledge. Most (57%) identified themselves as being at higher risk for a future AMI compared with an age-matched individual without heart disease with 1 exception. Namely, patients who had undergone coronary artery bypass surgery felt significantly less vulnerable for a future AMI than other individuals of the same age.
Conclusions:
Even following diagnosis of ACS and numerous interactions with physicians and other health care professionals, knowledge about ACS symptoms and treatment on the part of patients with cardiac disease remains poor. Patients require continued reinforcement about the nature of cardiac symptoms, the benefits of early treatment, and their risk status.
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