Arq Bras Cardiol. 2022 Jul;119(1):25-34. doi: 10.36660/abc.20210521.
ABSTRACT
BACKGROUND: Patient unawareness about acute myocardial infarction, its complications and the benefits of early revascularization is a crucial point that determines the outcomes. Moreover, the relationship between socioeconomic factors and patient presentation to primary percutaneous coronary intervention (PPCI) has not been fully studied.
OBJECTIVES: Our objective was to investigate whether or not patient unawareness and other socioeconomic factors impact patient presentation to PPCI.
METHODS: The study comprised 570 patients with ST-segment elevation myocardial infarction (STEMI) revascularized by PPCI. The patients were classified into two groups according to the total ischemia time (the time from STEMI symptom onset to balloon dilatation); group I: Patients with early presentation (1-12 hours). Group II: Patients with late presentation (>12-24 hours). Socioeconomic factors, clinical outcomes including mortality and major adverse cardiac events (MACE) were evaluated in each group. A p-value < 0.05 was considered statistically significant.
RESULTS: There are different socioeconomic factors affecting patient presentation to PPCI. Multivariate regression analysis identified the independent socioeconomic predictors as following: low educational level – OR 4.357 (CI95% 1.087-17.47, p=0.038), social isolation – OR 4.390 (CI95% 1.158-16.64, p=0.030) and unawareness about the benefits of early revascularization – OR 4.396 (CI95% 1.652-11.69, p=0.003). Mortality and MACE were higher in group II.
CONCLUSION: Patient unawareness and low socioeconomic status were associated with late presentation to PPCI with more adverse outcomes.
PMID:35830099 | DOI:10.36660/abc.20210521
