Factors Associated with Symptom-to-Door Delay in Patients with ST-Segment Myocardial Infarction: A Systematic Review
Xiuyan Lu1, Wei Xia1, Xinru Wang2
1Cardiology Department, Qingdao Hospital, University of Health and Rehabilitation Sciences (Qingdao Municipal Hospital), Qingdao, Shandong Province, China.
Insights
Reducing symptom-to-door delay in ST-segment elevation myocardial infarction (STEMI) is crucial. Female sex, older age, diabetes, hypertension, smoking, and self-transport are key factors contributing to this delay in STEMI patients.
Area of Science:
- Cardiology
- Public Health
- Medical Informatics
Background:
- Reducing symptom-to-door (S2D) delay is critical for improving outcomes in ST-segment elevation myocardial infarction (STEMI).
- Factors influencing S2D delay in STEMI patients require further characterization to inform targeted interventions.
Purpose of the Study:
- To identify and characterize the factors associated with symptom-to-door delay in ST-segment elevation myocardial infarction (STEMI) patients.
Main Methods:
- Systematic literature review of PubMed, CINAHL, and Embase databases.
- Manual searching of references from selected articles and relevant background papers.
- Semiquantitative synthesis to evaluate the level of evidence for identified factors.
Main Results:
- Twelve papers were included, identifying complex factors contributing to S2D delay.
- Strong evidence links female sex and diabetes to increased S2D delay.
- Moderate evidence indicates older age, smoking, hypertension history, and self-transport are associated with S2D delay.
Conclusions:
- Female sex, older age, diabetes, hypertension, smoking, and self-transport are significant risk factors for S2D delay in STEMI.
- Targeted public health education is needed for at-risk populations regarding STEMI symptoms and prompt medical attention.
Background:
Decreasing symptom-to-door (S2D) delay is of vital importance for reducing morbidity and mortality in patients with ST-segment elevation myocardial infarction (STEMI). The factors associated with S2D delay in STEMI patients have not been well-characterized.
Objectives:
The aim of this study was to identify factors associated with S2D delay in patients with STEMI.
Methods:
The PubMed, CINAHL, and Embase databases were searched for data. References from the selected articles and relevant background papers were also manually searched to identify additional eligible studies. The included articles were reviewed and assessed for risk of bias. The level of evidence for each identified factor was evaluated using a semiquantitative synthesis.
Results:
Twelve (12) papers were included in the review. Factors associated with S2D delay were complex and could be divided into sociodemographic, clinical history, and onset characteristics. The level of evidence regarding female sex and diabetes was strong, and the evidence was moderate regarding older age, smoking, history of hypertension, self-transport, or referral.
Conclusions:
Female sex, older age, previous diabetes, previous hypertension, smoking, and self-transport are all strong or moderate risk factors for S2D time delay in patients with ST-segment myocardial infarction. More efforts should be made to educate at-risk populations concerning symptoms of STEMI and the importance of seeking early medical assistance.
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