Acute myocardial infarction treatment delay in South Asia: a systematic review and meta-analysis.

Background: Acute Myocardial Infarction (AMI) necessitates timely treatment to improve outcomes. Identifying treatment delays across different South Asian countries can aid in formulating policies to reduce these delays. Objectives: To estimate the average treatment delay in AMI patients in South Asia and identify contributing factors.

Methods: Using the CoCoPop framework (Condition, Context, Population), studies were reviewed on AMI treatment delays in South Asia from 2000 to 2022. Databases searched included PubMed Central, Embase and Google Scholar. Eligible studies were cross-sectional and analytical that reported exact delay times, excluding knowledge, attitude, practice studies, narrative reviews, and case reports.

Results: The search yielded 2954 records, with 42 studies meeting the inclusion criteria. The pooled median prehospital delay was 531 minutes (95% CI: 366-769 minutes). The pooled mean door-to-ECG time was 9.18 minutes (95% CI: 2.52-15.84 minutes). The door-to-needle and door to balloon time among STEMI patients were 37.95 (95% CI: 30.11-45.78 minutes) minutes and 62.92 minutes (95% CI: 45.28-80.56 minutes), respectively with significant heterogeneity. Factors associated with delays included old age, female gender, low literacy, ignorance, financial constraints, and rural location.

Conclusion: Significant treatment delays for AMI patients in South Asia are identified, with socio-economic and logistical barriers contributing to these delays.