Abstract:

Objective To investigate the time delay in different phases from symptom onset to arrival at the hospital and time to treatment in patients with acute ST-segment elevated myocardial infarction(STEMI).Methods In this prospective,study,412 consecutive patients with confirmed STEMI were encolled in the(LuHe Hospital and Xuanwu Hospital) study from September 2003 to November 2004.The data were collected from patients' interviews and medical records.The following median times were recorded: patient's delay(PD),transportation delay(TD),prehospital delay(PHD),door to CCU(DTC),CCU to informed consent of reperfusion therapy,door to needling(DTN) and door to the first ballooning(DTB).Results A total of 412 patients with STEMI were enrolled.The following median times were recorded: PD 75 min;TD 50 min,PHD 170 min;door to CCU 30 min;252 patients received reperfusion therapy within 12 h after symptom onset,of which 145 patients received thrombolytic therapy,the remaining 107 patients performed primary angioplasty.Written informed consent in thrombolytic therapy and primary angioplasty was obtained in median times of 15 min and 46.5 min,respectively.Door to needling and door to ballooning times were 65 min and 135 min,respectively.Door to needling time of less than or equal to 60 min is achieved in 48.3% of patients,Door to ballooning time of less than 90 min and 120 min in 23.4% and 43.9%,respectively.Conclusion PD is the main cause of prehospital delay.The time of obtaining informed consent plays an important role in treatment delay.In-hospital delay is still higher than the guideline-recommended door-to-ballooning times.

Key words: myocardial infarction, delay, time