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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)? | LitMetric

AI Article Synopsis

  • High-risk perception (HRP) influences timely access to cardiac care after an acute myocardial infarction (AMI), but only 13.4% of patients in the study demonstrated favorable HRP levels.
  • Factors such as chest pain before the AMI, depression, and anxiety were linked to HRP, but demographic factors showed no significant difference between high and low risk perception patients.
  • Patients with higher HRP had significantly shorter median delays in reaching emergency care (127 minutes) compared to those with low risk perception (216 minutes), highlighting a dose-response relationship between risk perception and response times to seek treatment.

Article 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% (n = 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 (p = 0.0004), symptom mismatch during AMI (p < 0.0001), depression (p = 0.01), and anxiety (p = 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 127 min (interquartile range [IQR]: 83-43, p = 0.02) in HRP patients and 216 min (IQR: 106-721) in LRP patients. An increasing risk perception score was associated with a corresponding stepwise decline in median delay time (p > 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.

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Source
http://dx.doi.org/10.1007/s00059-024-05256-zDOI Listing

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