Abstract
Objectives: To assess the various delays in the timeline of STEMI, its
determinants, and impact on in-hospital outcomes.
Methodology: In this study we included STEMI patients who were either
presented late to ER or procedure was delayed. Pre-hospital delay was
defied as chest pain (CP) to ER arrival time ≥120 minutes and hospital
delay was defined as ER to procedure time ≥90 minutes. Reasons for prehospital and hospital delays and in-hospital complications and outcomes
were recorded.
Results: A total of 103 patients, 72.8%(75) male, with mean age of
54.75±11.8 years were enrolled. Median duration between CP and ER
arrival 240[420-144.5] minutes with ≥120 minutes for 89.3%(92).
Procedure was performed in 120[180-60] minutes of ER arrival with ≥90
minutes for 61.2% (63). Pre-hospital delay was caused by unawareness of
symptoms (53.3%) followed by unavailability of transportation (29.3%),
while, hospital delayed was caused by unavailability of resources (69.8%).
Pre-hospital delay of ≥360 minutes was associated with higher rate of LV
thrombus, 21.4% vs. 1.3%; p<0.001, and in-hospital re-current ischemia,
32.1% vs. 12%; p=0.017.
Conclusions: In this study we observed that the most common causes of
pre-hospital delay in our population are unawareness of symptomology
and unavailability of transportation, while, the major cause of hospital delay
was unavailability resources. Pre-hospital delay was associated with
significantly higher rate of LV thrombus and in-hospital re-current ischemia.
Sanam Khowaja, Salik Ahmed, Tariq Ashraf, Mahesh Kumar Batra, Saher Khowaja, Mehak Nazir, Muneeba Khan, Musa Karim, Kamran Ali Khowaja. (2021) Various Delays And Its Determinants In The Timeline Of St-segment Elevation Myocardial Infarction, Pakistan Heart Journal, Volume-54, Issue-1.
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