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.
