Factors Influencing Delay in Symptom-to-Door Time in Patients with Acute ST-Segment Elevation Myocardial Infarction

Background/Aims: Delay in symptom-to-door time (SDT) in patients with acute ST-segment elevation myocardial infarction (STEMI) is the most important factor in the prediction of short and long-term mortality. The purpose of this study was to investigate the social and clinical factors affecting SDT in patients with STEMI. Methods: We analyzed 784 patients (61.0 ± 13.2 years, 603 male) diagnosed with STEMI from November 2005 to February 2012. The patients were divided into four groups according to SDT: Group I (n = 163, ≤ 1 h), Group II (n = 183, 1-2 h), Group III (n = 142, 2-3 h) and Group IV (n = 296, > 3 h). Results: Delay in SDT increased with age (Group I, 58.4 ± 12.0; Group II, 59.4 ± 13.3; Group III, 62.0 ± 12.8; Group IV, 63.0 ± 13.8 years, p = 0.001). In 119 patients, transportation was less frequently used as the delay in SDT (41.7% vs. 29.0% vs. 26.1% vs. 9.8%, p < 0.001). By multiple logistic regression analysis, family history [OR, 0.488; CI, 0.248-0.959; p = 0.037], previous ischemic heart disease [OR, 0.572; CI, 0.331-0.989; p = 0.045], no occupation [OR, 1.600; CI, 1.076-2.380; p = 0.020] and method of transportation [OR, 0.353; CI, 0.239-0.520; p < 0.001] were independent predictors of delay in SDT. Conclusions: Our study shows that general education about cardiovascular symptoms and a prompt emergency call could be important to reduce SDT in STEMI. (Korean J Med 2014;87:429-438)