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Many Patients With Heart Attack Delay Hospital Care
Date:11/8/2010

ttack starts when you first develop symptoms, not with the first medical contact. There's an upstream component when a patient develops symptoms before they decide to call 911 or come into the hospital."

Ting and his colleagues analyzed data on more than 104,000 patients who had arrived at one of 568 hospitals with a non-STEMI heart attack from the beginning of 2001 to the end of 2006. This information was included in a national registry funded by several pharmaceutical companies, although this study was not funded by those firms.

The median delay time of 2.6 hours did not budge during the six-year time period. Fifty-nine percent of patients took more than two hours to get to the hospital while 11 percent took 12 hours after symptoms started.

Women, along with people who were older or non-white, who had diabetes or were current smokers were the least likely to seek timely care.

And patients who arrived at the hospital during weekday and weekend nights -- between 12 a.m. and 8 a.m. -- had 25 percent shorter delay times than patients who arrived between 8 a.m. and 4 p.m. on weekdays, the investigators found.

But, the delays didn't seem to be associated with mortality, at least with the non-STEMI patients in the study.

The study findings suggest that initial assumptions about the cause of the delays -- that patients simply didn't know they were having a heart attack -- may be wrong, the study authors said.

"There may be other reasons why patients delay," Ting said.

Previous studies have found that both an individual's trust in the health-care system and their insurance status have influenced when they call for help.

"It may not be, 'I don't know what the symptoms are,' but more, 'Do I trust the system?' and 'Can I pay for it?'" Ting said.

Another study, this one published in the November issue of Archives of Neurology, found that patients with an ischemic stroke who receive and respond to the clot
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