Arq. Bras. Cardiol. 2022; 119(1): 25-34
Impact of Patient Unawareness and Socioeconomic Factors on Patient Presentation to Primary Percutaneous Coronary Intervention
Mohamed Khalfallah
, Amany Allaithy
, Dina A. Maria
This Original Article is referred by the Short Editorial "If “Time Is Muscle,” Then the Patient’s Knowledge Must Save Time".
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.
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