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Prevalence of aspirin use among patients calling 9-1-1 for chest pain
M B Jaffy1, H Meischke, M S Eisenberg
1University of Washington School of Medicine, Seattle, USA. jaffymb@u.washington.edu
Insights
Few patients experiencing chest pain self-administer aspirin before emergency medical services (EMS) arrive. Those already taking aspirin regularly are more likely to take it for acute chest pain.
Area of Science:
- Cardiology
- Emergency Medicine
- Pharmacology
Background:
- Early aspirin administration during acute myocardial infarction (AMI) is proven to reduce morbidity and mortality.
- Chest pain is the most commonly recognized symptom of AMI by the public.
Purpose of the Study:
- To determine the prevalence of pre-hospital aspirin self-administration by patients presenting with chest pain.
- To identify factors influencing aspirin self-administration in suspected AMI cases.
Main Methods:
- Prospective, cross-sectional prevalence study.
- Analysis of emergency medical services (EMS) incident reports for chest pain complaints between June 1, 1997, and August 31, 1997.
Main Results:
- Out of 694 subjects, only 15% (102) self-administered aspirin before EMS arrival.
- Patients on regular aspirin therapy were more likely to take additional aspirin (26%) compared to those not on regular therapy (5%).
- Lower chest pain intensity was associated with a higher likelihood of aspirin self-administration.
Conclusions:
- A small proportion of individuals with acute chest pain self-administer aspirin prior to EMS arrival.
- Regular aspirin users are more likely to self-administer aspirin during acute chest pain episodes.
- Severity of chest pain may influence the decision to self-administer aspirin.
Objective:
Early aspirin administration during an acute myocardial infarction (AMI) decreases morbidity and mortality. This investigation examined the extent to which patients with a complaint of chest pain, the symptom most identified with AMI by the general population, self-administer aspirin before the arrival of emergency medical services (EMS) personnel.
Methods:
In this prospective, cross-sectional prevalence study, data were derived through the analysis of EMS incident reports for patients with a complaint of chest pain from June 1, 1997, to August 31, 1997.
Results:
The study included 694 subjects. One hundred two (15%) took aspirin for their chest pain before the arrival of EMS personnel. Of the 322 subjects who reported taking aspirin on a regular basis, 82 (26%) took additional aspirin for their acute chest pain. Only 20 (5%) of the 370 patients who were not using regular aspirin therapy self-administered aspirin acutely (p<0.001). In addition, patients with lower intensity of chest pain (p = 0.03) were more likely to take aspirin for their chest pain.
Conclusion:
Only a relatively small fraction of individuals calling 9-1-1 with acute chest pain take aspirin prior to the arrival of EMS personnel. These individuals are more likely to self-administer aspirin if they are already taking it on a regular basis. It is also possible that they are less likely to take aspirin if their chest pain is more severe.