Time lag to hospitalisation and the associated determinants in patients with acute myocardial infarction: the Takashima AMI Registry, Japan

BACKGROUND: Prompt initiation of treatment is the cornerstone in the management of patients with acute myocardial infarction (AMI). The time lags for AMI hospitalisations were examined to identify the factors influencing the interval. METHODS: Time lag information was available for 273 men and 148 women from the Takashima AMI Registry during 1988-2006. Multivariate regression analyses were performed to evaluate the factors influencing early and late admission. RESULTS: The median time to hospitalisation was 2 h (mean 6.1, SD 18.7). Within 2 h of onset, 59.8% patients arrived and 20.6% arrived during the 2-6 h interval. A substantial number of patients (19.6%) arrived after 6 h and onwards. A time lag of >2 h in hospital admission was significantly influenced by history of hypertension, angina, presence of syncope as an initial symptom and time of AMI onset. A time lag of >6 h shared similar characteristics except for presence of history of angina. CONCLUSIONS: About one-fifth of patients with AMI have prolonged time lag in the study population. Future research intervention and health promotion activities should focus on achieving a reduction in presentation delays.