Is an accurate self-perceived health risk beneficial for patients to minimize prehospital delay time at onset of a ST-segment elevated myocardial infarction (STEMI)?
Herz
; 49(4): 270-276, 2024 Aug.
Article
de En
| MEDLINE
| ID: mdl-38965126
ABSTRACT
High risk perception (HRP) is fundamental for adequate health behavior. However, its impact on rapid access to cardiac care after the onset of acute myocardial infarction (AMI) is not known. Conflicting evidence exists about sources that promote HRP. Data on sociodemographic and clinical characteristics of 588 AMI patients who participated in the Munich Examination of Delay in Patients Experiencing Acute Myocardial Infarction (MEDEA) study were collected at the bedside. Adjusted multivariate logistic regression models identified factors associated with HRP. Only 13.4% (nâ¯= 79) of patients had a favorable HRP level. The HRP patients did not differ from those with low risk perception (LRP) in terms of sex, age, other sociodemographic features, and somatic risk factors. Among the univariate contributors to HRP were prodromal chest pain (pâ¯= 0.0004), symptom mismatch during AMI (pâ¯< 0.0001), depression (pâ¯= 0.01), and anxiety (pâ¯= 0.005). However, family history of AMI, a previous AMI, and knowledge of AMI remained significant in the multivariate regression model. Median delay time to reach a hospital-based emergency facility after the onset of AMI was 127â¯min (interquartile range [IQR] 83-43, pâ¯= 0.02) in HRP patients and 216â¯min (IQR 106-721) in LRP patients. An increasing risk perception score was associated with a corresponding stepwise decline in median delay time (pâ¯> 0.004). Self-perceived AMI risk is associated in a dose-response relationship with the time needed to reach coronary care emergency facilities. Recurrent AMI, family history of AMI, and sufficient knowledge of MI contribute to risk perception, whereas somatic risk factors do not.
Mots clés
Texte intégral:
1
Collection:
01-internacional
Base de données:
MEDLINE
Sujet principal:
Services des urgences médicales
/
Infarctus du myocarde avec sus-décalage du segment ST
Limites:
Aged
/
Female
/
Humans
/
Male
/
Middle aged
Pays/Région comme sujet:
Europa
Langue:
En
Journal:
Herz
Année:
2024
Type de document:
Article
Pays d'affiliation:
Allemagne
Pays de publication:
Allemagne