Pablo Juan-Salvadores, Luis Mariano De La Torre Fonseca, Beatriz Calderon-Cruz, Cesar Veiga, Samuel Pintos-Rodríguez, Saleta Fernandez Barbeira, Victor Alfonso Jimenez Diaz, Andres Iñiguez Romo
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引用次数: 0
Abstract
Introduction: ST-elevation myocardial infarction (STEMI) is one of the most prevalent presentations in young patients. It is essential to emphasise that each minute of delay in providing medical care is negatively correlated to the patient's prognosis. The present study was carried out to evaluate the ischaemia-reperfusion times in patients ≤40 years of age versus individuals >40 years of age and their association with mortality and major adverse cardiac event (MACE) over the long term.
Methods: A retrospective, multicentre cohort study was carried out in 6799 patients diagnosed with STEMI. Two groups were established: patients diagnosed with STEMI and aged >40 years, and patients diagnosed with STEMI and aged ≤40 years.
Results: The patients in the young group had a significantly sooner electrocardiographic diagnosis than the patients >40 years of age. A delay was observed in females, with a relative risk (RR) of 1.21 (95% CI 1.13 to 1.30) (p<0.001). Presenting dyspnoea (RR 1.76, 95% CI 1.5 to 2.06) (p<0.001) or going to a hospital without haemodynamics (RR 1.55, 95% CI 1.45 to 1.67) (p<0.001) was related to increased delay. The occurrence of MACE in the first year of follow-up was related to different risk factors, along with a delay in healthcare (HR 1.25, 95% CI 1.10 to 1.54) (p<0.042).
Conclusion: This study shows that young patients with STEMI tend to receive a sooner diagnosis than older individuals. Delays in healthcare represent one of the main factors related to the occurrence of MACE and non-event-free survival.
期刊介绍:
Open Heart is an online-only, open access cardiology journal that aims to be “open” in many ways: open access (free access for all readers), open peer review (unblinded peer review) and open data (data sharing is encouraged). The goal is to ensure maximum transparency and maximum impact on research progress and patient care. The journal is dedicated to publishing high quality, peer reviewed medical research in all disciplines and therapeutic areas of cardiovascular medicine. Research is published across all study phases and designs, from study protocols to phase I trials to meta-analyses, including small or specialist studies. Opinionated discussions on controversial topics are welcomed. Open Heart aims to operate a fast submission and review process with continuous publication online, to ensure timely, up-to-date research is available worldwide. The journal adheres to a rigorous and transparent peer review process, and all articles go through a statistical assessment to ensure robustness of the analyses. Open Heart is an official journal of the British Cardiovascular Society.