Highlights
- -Time delays in STEMI patients admitted to Emergency Department (ED) are longer in women and elderly.
- -STEMI delays are longer particularly in women and elderly with atypical presentation.
- -Older and first medical contact outside the ED have longer activation time.
- -Gender and age are not associated with a longer activation time in young people.
- -Activation time is particularly longer in older women.
Abstract
Background
: Time between Emergency Department (ED) and ST-segment elevation acute myocardial
infarction (STEMI) activation time is a good indicator of ED quality. STEMI delays
are of particular importance in some subgroups, such as women and the elderly.
Objective
: To determine the association of sex and age with activation time in STEMI patients
admitted to the ED.
Methods
: An observational retrospective study was conducted including all patients admitted
to the ED activated as a STEMI. The main variable was activation time. To evaluate
the independent predictors of activation time, a multivariate logistic regression
analysis was carried out, variables were sex, age, sex and age combined, chest pain,
ST elevation in the electrocardiogram, and first medical contact (FMC) at the hospital's
ED.
Results
: A total of 330 patients were included. They were classified by sex: 23.9% (78) women
and 76.1% (249) men; and age: 51.1% (167) <65 yo and 48.9% (160) ≥65 yo. Women and
elderly patients exhibited a more atypical presentation. Multivariate analysis shows
that showed that elderly age (OR=1.976 95%; CI=1.257–3.104; p = 0.003) and FMC prior to attending the ED (OR=1.762; 95% CI=1.117–2.779; p = 0.015) were associated with a longer activation time. Women older than 65 years old showed
the longest activation time.
Conclusion
: STEMI delays are longer in women and the elderly with atypical presentation. Age
≥65 and FMC outside the ED were associated with an increase in the activation time.
This highlights the need to develop strategies to improve activation time for these
specific patient groups.
Keywords
Abbreviations:
CAD (coronary artery disease), CRA (cardiorespiratory Arrest), DLP (dyslipidaemia), DM (diabetes mellitus), ECG (electrocardiogram), ED (emergency department), ESC (European Society of Cardiology), FMC (first medical contact), GPC (general poor condition), HTA (arterial hypertension), IC (interventional cardiology), Min (minutes), PCI (percutaneous coronary intervention), STEMI (St-Segment Elevation Acute Myocardial Infarction), Yo (years old)To read this article in full you will need to make a payment
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Article info
Publication history
Published online: November 03, 2022
Accepted:
October 25,
2022
Received in revised form:
October 25,
2022
Received:
March 12,
2022
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
