Age-related trends in prehospital delay time interval and reperfusion therapy in patients with ST elevation acute myocardial infarction

Background

The literature states that age relates to prehospital delay time interval from acute symptom onset to emergency department admission. Several studies indicate that patients of advanced age are more likely to experience delayed reperfusion therapy after hospital presentation. This study aims to assess time to treatment differences between patients under 75 years old and elderly patients.

Methods

Prospective study of 116 admissions with ST elevation acute myocardial infarction (STEAMI) who received primary percutaneous transluminal coronary angioplasty (PTCA) treatment for STEAMI in a tertiary hospital over a 2-year period (March 1999-March 2001). Prehospital delay time (ΔT1) was measured, as well as time between hospital presentation and establishment of reperfusion therapy (ΔT2) and time between initial puncture and balloon insufflation in a cardiac catheterization laboratory (ΔT3). Epi-info 6.0 software was used to perform statistical analyses.

Results

Among a cohort of 116 patients, 70.6% were men; the mean age was 64.8 ± 13 years and 24.2% were over 75 years old. Mean ΔT1 in patients under 75 years old was 218.3 min and in patients over 75 years old was 212.8 min (P = 0.6). Mean ΔT2 in younger patient was 52.1 min and in advanced-age patients was 54.1 min (P = 0.6). Mean ΔT3 in patients under 75 years old was 25.5 min and in elderly was 20.8 min (P = 0.5).

Conclusion

Prehospital delay time interval was similar between elderly patients and patients under 75 years. Time to establishment reperfusion therapy and time to treatment with primary PTCA was not different among these patients. The more rapid treatment of appropriate elderly patient with STEAMI probably reduces mortality rates.