73 Patient-related delay to seeking healthcare treatment in ST-elevation myocardial infarction (STEMI): an analysis of 30 patients from the pathway analysis project in STEMI (PAP-STEMI) study

Introduction Delay to coronary revascularization is associated with poor outcomes in patients with ST-elevation myocardial infarction (STEMI). Little is known about patient related decision making and its impact on delay to seeking healthcare treatment in STEMI. Methods Data from 30 consecutive patients in the Pathway Analysis Project in STEMI (PAP-STEMI) study was analysed. This retrospective cohort study included consecutive patients with a diagnosis of STEMI at the University Hospital St. Polten in Austria who consented to take part in the study. Data was collected from hospital records and telephone interviews and statistical analysis consider the group with <30 and >30 minutes delay related to patient decision making was performed on STATA. Results A total of 17 patients (56.7%) had greater than 30 minutes of delay before seeking help. There was no significant difference in age (median 62 vs 59 years), proportion of male (70.6% vs 69.2%) and the distance they lived from the hospital (median 60 vs 35 km) comparing those with and without delay. The patients with delay had a greater prevalence of diabetes mellitus (35.3% vs 0%), previous myocardial infarction (29.4% vs 0%), and previous PCI (29.4% vs 0%). From onset of symptoms only 4 patients called for help right away and 8 patients decided to see their general practitioner (GP) for symptoms related to STEMI. STEMI was only identified in 4 out of 8 patients by their GP. A total of 6 patients had a peri-event visit to the GP and may have had a missed opportunity for an earlier diagnosis or treatment. A total of 19 patients had typical symptoms of STEMI while 21 had atypical symptoms and 13 patients thought they had an acute myocardial infarction when they developed symptoms during their STEMI. Conclusion Patient related delay to seeking healthcare professionals when they develop symptoms is common in patients with an eventual diagnosis of STEMI and is more common in patients with diabetes mellitus and previous myocardial infarction. Some patients decide to seek help from GP during their STEMI and only half were correctly identified as having STEMI. Conflict of Interest None