FACTORS ASSOCIATED WITH DELAYS IN SEEKING MEDICAL CARE IN MYOCARDIAL INFARCTION
https://doi.org/10.17802/2306-1278-2017-6-3-104-112
Abstract
Purpose. To assess factors associated with pre-hospital delay in seeking medical care in patients with myocardial infarction.
Materials and Methods: 51 patients with myocardial infarction, included in the original single-center research trial, were surveyed to assess the differences in the time intervals from the onset of symptoms to the decision to seek medical care, as well as the factors, associated with delay in calling emergency medical service.
Results. We found that the majority of patients (> 70%) with myocardial infarction, admitted to the Kemerovo Regional Clinical Cardiology Dispensary, applied for medical care within 6 hours from the onset of symptoms. However, there was a group of patients with increased pre-hospital delay time. Patient delay may affect the effectiveness of treatment for acute coronary syndrome. These patients were commonly of younger age and males, with higher education working in the urban areas. Information campaigns targeted at this group of patients should be launched to raise their awareness and highlight the crucial role of prompt and timely calling EMS after the onset of myocardial infarction.
Conclusion. It seems to be a rationale to launch informational campaigns targeting this group of patients (young working men living in large industrial cities) to highlight the importance of early and prompt seeking of medical care after the onset of MI symptoms.
About the Authors
D. O. KosyaginUnited States
Las Vegas, Nevada
P. N. Zavyrilina
Russian Federation
Kemerovo
D. Yu. Sedih
Russian Federation
Kemerovo
I. S. Bykova
Russian Federation
Kemerovo
V. V. Kashtalap
Russian Federation
Kemerovo
References
1. Kashtalap V.V., Zavyrilina I.N., Barbarash O.L. Endovascular revascularization in acute coronary syndrome with ST segment elevation in Russia: problems and prospects for further development. Creative cardiology; (3): 5-15. [in Russian]. Кашталап В.В., Завырылина И.Н., Барбараш О.Л. Эндоваскулярная реваскуляризация при остром коронарном синдроме с подъемом сегмента ST в России: проблемы и перспективы дальнейшего развития. Креативная кардиология. 2015; (3): 5-15.
2. Ганюков В.И., Протопопов А.В. «Stent for life» Siberia. История. Задачи. План действий на 2013 год. Комплексные проблемы сердечно-сосудистых заболеваний. 2013; 1: 35–9. Ganyukov VI, Protopopov AV «Stent for life» Siberia. History. Tasks. Action plans for 2013. Complex issues of cardiovascular diseases. 2013; 1: 35-39. [in Russ].
3. Барбараш О.Л., Кашталап В.В. Роль фармакоинвазивной тактики ведения пациентов с острым коронарным синдромом с подъемом сегмента ST в России. Кардиология. 2014; 54 (9):79–85. Barbarash OL, Kashtalap V.V. Role of pharmacoinvasive management tactics for patients with acute coronary syndrome with ST segment elevation in Russia. Kardilogiya. 2014; 54 (9): 79-85. [in Russ].
4. Armstrong P.W., Gershlick A.H., Goldstein P. et al. Fibrinolysis or primary PCI inST-segment elevation. N. Engl. J. Med. 2013; 368: 1379-87.
5. Бокерия Л.А., Алекян Б.Г. Состояние эндоваскулярной диагностики и лечения заболеваний сердца и сосудов в Российской Федерации (2004–2013 гг.). Эндоваскулярная хирургия. 2014;1 (1): 6–19. Bokeriya LA, Alekyan BG The state of endovascular diagnostics and treatment of heart and vascular diseases in the Russian Federation (2004-2013) Endovascular surgery. 2014; 1 (1): 6-19. [in Russ].
6. Van de Werf F. The history of coronary reperfusion. Eur. Heart J. 2014; 35, 2510-5.DOI: 10.1093 / eurheartj / ehu268.
7. Скрыпник Д.В., Резцов Р.Ю., Макарычева О.В., Коновалова Е.В., Васильева Е.Ю., Шпектор А.В. Современные подходы к лечению острого инфаркта миокарда с подъемом сегмента ST. Креативная кардиология. 2014; 2: 5–14. Skrypnik DV, Reztsov R.Yu., Makarycheva OV, Konovalova EV, Vasilyeva E.Yu., Shpektor A.V. Modern approaches to the treatment of acute cardiac infarction with the elevation of the ST segment. Creative cardiology. 2014; 2: 5-14. [in Russ].
8. Boersma Е., The Primary Coronary Angioplasty vs. Thrombolysis (PCAT)-2 Trialists’ Collaborative Group; Does time matter? A pooled analysis of randomized clinical trialscomparing primary percutaneous coronary intervention and inhospital fibrinolysis inacute myocardial infarction patients. Eur Heart J. 2006; 27 (7): 779-788. doi:10.1093/eurheartj/ehi810.
9. Европейское общество кардиологов (ESC), Европейская ассоциация кардиоторакальных хирургов (EACTS). Рекомендации по реваскуляризации миокарда 2014. Российский кардиологический журнал. 2015; 2 (118): 5–81. European Society of Cardiology (ESC), European Association of Cardiothoracic Surgeons (EACTS). Recommendations for revascularization of the cardiovascular system 2014. Russian cardiological journal. 2015; 2 (118): 5-81. [in Russ].
10. Ганюков В.И., Тарасов Р.С., Коваленко О.В., Херасков В.Ю., Артамонова Г.В., Моисеенков Г.В., Барбараш О.Л., Барбараш Л.С. Организация реперфузионной терапии больным острым инфарктом миокарда с элевацией сегмента ST в Кемерово. Сибирский медицинский журнал. 2010; 25(2), выпуск 1: 106. Ganyukov V.I., Tarasov R.S., Kovalenko O.V., Kheraskov V.Yu., Artamonova G.V., Moiseenkov G.V., Barbarash O.L., Barbarash L.S. Organization of reperfusion therapy for patients with acute myocardial infarction with ST segment elevation in Kemerovo. Siberian Medical Journal. 2010; 25(2), issue 1: 106. [in Russ].
11. Kristensen S. D., Fajadet J., Di Mario C., Kaifoszova Z., Laut K. G., Deleanu D., Gilard M., Guagliumi G., Goktekin O., Jorgova J., Kanakakis J., Ostojic M., Pereira H., Sabate M., Sobhy M., Vrints C., Wijns W., Widimsky P. Implementation of primary angioplastyin Europe: stent for life initiative progress report. EuroIntervention. 2012 May15; 8 (1): 35-42. Doi: 10.4244/EIJV8I1A7.
12. Steg P., James S.K. , Atar D., Badano L. P., Lundqvist C. B., Borger M.A. Ducrocq G.ESC Guidelines for the management of acute myocardial infarction in patients presentingwith ST-segment elevation: The Task Force on the Management of ST-segment elevationacute myocardial infarction of the European Society of Cardiology (ESC). Eur Heart J. 2012; 33 (20): 2569-2619.DOI: https://doi.org/10.1093/eurheartj/ehs215.
13. Барбараш О.Л. Европейская программа «Stent for life»: предпосылки, история создания, основные цели и задачи. Комплексные проблемы сердечно-сосудистых заболеваний. 2013;(1):10-18. Barbarash O.L. European program «Stent for life»: prerequisites, history of creation, main goals and objectives. Complex issues of cardiovascular diseases. 2013; 1: 10-18. DOI: 10.17802 / 2306-1278-2013-1-10-18. [in Russ.].
14. Kaifoszova Z. Stent for Life Initiative: Leading Example in Building STEMI Systems of Care in Emerging Countries. EuroIntervention. 2014; 8 (10 ) Suppl T: T87-T95.
15. Ганюков В.И., Шилов А.А. К вопросу о выполнении рекомендованных лечебных мероприятий у больных острым коронарным синдромом в кардиологических учреждениях на территории Российской Федерации. Кардио-ИТ. 2015; 2(2): e0201. Ganyukov V.I., Shilov A.A. To the question of the implementation of recommended therapeutic measures in patients with acute coronary syndrome in cardiological institutions on the territory of the Russian Federation. Cardio-IT. 2015; 2 (2): e0201. [in Russ].
16. Kanakakis J., Ntalianis A., Papaioannou G., Hourdaki S., Parharidis G. Stent for LifeInitiative - the Greek experience. EUROINTERVENTION. 2012 Aug; 8 Suppl :P116-20. doi: 10.4244/EIJV8SPA20.
17. Hélder Pereira, Fausto J. Pinto, Rita Calé, Ernesto Pereira, Jorge Marques, ManuelAlmeida et al. Stent for Life in Portugal: This initiative ishere to stay. Revista Portuguesa de Cardiologia. 2014; 33 (6): 363-370.
18. Kristensen S.D., Laut K.G., Kaifoszova Z., Widimsky P. Variable Penetration of Primary Angioplasty in Europe-WhatDetermines the Implementation Rate? EuroIntervention.2012; 8 (l): 18-26.
19. Keeley C., Boura J.A., Grines C.L. Primary angioplasty versus intravenoushrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomized trials. Lancet. 2003; 361: 13-20.
20. Zijlstra F., Hoorntje J.C., de Boer M.J., Reiffers S., Miedema K. Long-termbenefit of primary angioplasty as compared with thrombolytic therapy for аcute myocardial infarction. N. Engl. J. Med. 1999; 341: 1413-9.
Review
For citations:
Kosyagin D.O., Zavyrilina P.N., Sedih D.Yu., Bykova I.S., Kashtalap V.V. FACTORS ASSOCIATED WITH DELAYS IN SEEKING MEDICAL CARE IN MYOCARDIAL INFARCTION. Complex Issues of Cardiovascular Diseases. 2017;(3):104-112. (In Russ.) https://doi.org/10.17802/2306-1278-2017-6-3-104-112