Time to Treatment Delay and Clinical Indicators in Patients with ST-Segment Elevation Myocardial Infarction: A Descriptive Cross-sectional Study.

Abstract

Introduction: ST-segment elevation myocardial infarction (STEMI) continues to be a significant global health issue, necessitating ongoing monitoring of care processes to enhance quality. This study aimed to examine time to treatment delay and clinical indicators in patients with STEMI undergoing primary percutaneous coronary intervention (PPCI).

Methods: This descriptive cross-sectional study was conducted with the recruitment of 313 patients with STEMI treated with PPCI Tabriz (Iran) in 2023. Data were analyzed using descriptive statistics, the Mann-Whitney U test, the Kruskal-Wallis test, the chi-square test, and regression analysis in SPSS v.13 software.

Results: Most of the patients were men and half of them were 60 years old or younger. The median door-to-balloon time [IQR] was 80 [49-140] minutes. The pre-PCI center delay time and treatment delay time were 191 and 310 minutes, respectively. There was a statistically significant association between the patient's place of residence, the admission type in the PCI center, and the pre-PCI center delay time. In addition, there was a statistically significant association between treatment delay time, left ventricular ejection fraction (LVEF), baseline troponin I level, angioplasty outcome, and receiving acute coronary syndrome (ACS) drugs at the pre-PCI center.

Conclusion: The longer pre-PCI center delay time resulted in a longer total treatment delay. To reduce delays, it is proposed to improve the logistics surrounding these procedures for patients with STEMI and to provide appropriate education about the STEMI management program to all stockholders.