Longer pre-hospital delay in first myocardial infarction among patients with diabetes: an analysis of 4266 patients in the Northern Sweden MONICA Study
2013 (English)In: BMC Cardiovascular Disorders, ISSN 1471-2261, E-ISSN 1471-2261, Vol. 13, no 6Article in journal (Refereed) Published
Background: Reperfusion therapy reduces both morbidity and mortality in myocardial infarction, but the effectiveness depends on how fast the patient receives treatment. Despite the time-dependent effectiveness of reperfusion therapy, many patients with myocardial infarction have delays in seeking medical care. The aim of this study was to describe pre-hospital delay in a first myocardial infarction among men and women with and without diabetes and to describe the association between pre-hospital delay time and diabetes, sex, age, symptoms and size of residential area as a proxy for distance to hospital.
Methods: This population based study was based on data from 4266 people aged 25-74 years, with a first myocardial infarction registered in the Northern Sweden MONICA myocardial infarction registry between 2000 and 2008.
Results: The proportion of patients with delay times >= 2 h was 64% for patients with diabetes and 58% for patients without diabetes. There was no difference in delay time >= 2 h between men and women with diabetes. Diabetes, older age and living in a town or rural areas were factors associated with pre-hospital delay times >= 2 h. Atypical symptoms were not a predictor for pre-hospital delay times >= 2 h, OR 0.59 (0.47; 0.75).
Conclusions: A higher proportion of patients with diabetes have longer pre-hospital delay in myocardial infarction than patients without diabetes. There are no differences in pre-hospital delay between men and women with diabetes. The largest risk difference for pre-hospital delay >= 2 h is between women with and without diabetes. Diabetes, older age and living in a town or rural area are predictors for pre-hospital delay >= 2 h.
Place, publisher, year, edition, pages
BioMed Central, 2013. Vol. 13, no 6
Myocardial infarction, Diabetes mellitus, Pre-hospital delay, Sex differences
Cardiac and Cardiovascular Systems
IdentifiersURN: urn:nbn:se:umu:diva-67051DOI: 10.1186/1471-2261-13-6ISI: 000314586000001OAI: oai:DiVA.org:umu-67051DiVA: diva2:612716
FunderSwedish Research CouncilSwedish Heart Lung Foundation