Factors Associated With Delayed Presentation for Myocardial Infarction Among Patients in Iraq

Area of Science:

• Cardiology
• Public Health
• Epidemiology

Background:

• Myocardial infarction (MI) is a primary cause of global mortality, necessitating timely intervention.
• Delays in hospital presentation for MI are prevalent, particularly in low- and middle-income countries.
• Iraq faces challenges in optimizing early reperfusion therapy for acute myocardial infarction patients.

Purpose of the Study:

• To investigate the prevalence and factors associated with delayed hospital presentation in acute myocardial infarction (MI) patients in Iraq.
• To identify demographic and clinical characteristics linked to delayed MI diagnosis and treatment initiation.

Main Methods:

• A cross-sectional retrospective study involving 150 adult acute MI patients in Baghdad, Iraq (April-October 2025).
• Data collected from medical records included demographics, clinical factors, and time from symptom onset to emergency department presentation.
• Statistical analysis using Fisher's exact test identified significant associations (p<0.05) with delayed presentation (>12 hours).

Main Results:

• A significant majority (60.7%) of patients presented more than 12 hours after symptom onset.
• Delayed MI presentation was strongly associated with older age (≥55 years), diabetes mellitus, and dyslipidemia.
• Nighttime symptom onset (12 AM-8 AM) was also significantly linked to delayed presentation, unlike gender, BMI, or hypertension.

Conclusions:

• Over 60% of acute myocardial infarction patients in Iraq experience delays exceeding 12 hours for hospital presentation.
• Key factors contributing to delayed presentation include older age, presence of diabetes, dyslipidemia, and symptom onset during nighttime hours.
• Targeted patient education and public health initiatives addressing these specific factors are crucial for improving MI outcomes in Iraq.