In patients with ST-segment non-elevation myocardial infarction, a study result showed that delay in hospital admission after symptom onset increases the long-term mortality rate.
Acute myocardial infarction is divided into ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) according to the presence or absence of ST-segment elevation on the electrocardiogram. ST-segment elevation myocardial infarction occurs when large blood vessels in the heart are blocked, and the symptoms are usually severe. In ST-segment elevation myocardial infarction, small blood vessels are blocked.
A research team led by Professor Tae-Hoon Ahn, Professor Jung-Jun Cha of Cardiology Department, Yongin Severance Hospital, and Professor Seong-A Bae of the Department of Cardiology at Korea University Anam Hospital, Korea University Anam hospital analyzed. As a result, it was confirmed that long-term mortality in patients with non-ST-segment elevation acute myocardial infarction increased rapidly if they arrived at the hospital 24 hours after symptom onset.
In particular, this study suggests the possibility that the tendency to avoid hospital treatment after the outbreak of COVID-19 is closely related to the increase in the mortality rate from acute myocardial infarction in the era of the COVID-19 infectious disease, which has not been able to explain the clear reason.
The research team analyzed prognostic differences in patients with ST-segment non-elevation myocardial infarction by dividing the group into the group who arrived within 24 hours of symptom onset and the group who arrived after 24 hours. As a result, the three-year risk of death was 1.62 times higher in the group of patients arriving after 24 hours compared to those who visited the hospital within 24 hours. It was confirmed that the factors for the delay in arriving at the hospital after 24 hours were the elderly, women, non-specific chest pain, dyspnea, diabetic patients, and non-use of the 119 ambulance.
Professor Ahn Tae-hoon said, “This research report is an important study showing that it is very important for the long-term prognosis of myocardial infarction patients to visit the hospital quickly and get an accurate diagnosis and treatment when there is chest pain or shortness of breath in the Corona era.” .
Professor Cha Jeong-joon explained, “Through this study, we were able to confirm that delay in hospital visits for patients with acute myocardial infarction is an important factor that increases the risk of death regardless of the underlying disease.” He continued, “Korea has an excellent medical system in the world, and the treatment technology for cardiovascular diseases is also world-class. Therefore, through continuous publicity and information sharing on the symptoms of acute myocardial infarction, patients with acute myocardial infarction can visit the hospital within an appropriate time. “Social efforts are needed to make it happen,” he said.
Professor Bae Seong-ah said, “In the case of ST-segment elevation myocardial infarction, it is often accompanied by severe symptoms, and many come to the hospital immediately. There are many cases, but it is very important to visit the hospital early and receive treatment using the emergency medical system,” he said.
Meanwhile, this study ‘Clinical Outcomes in Patients With Delayed Hospitalization for Non-ST-Segment Elevation Myocardial Infarction’ was published in the latest issue of ‘Journal of the American College of Cardiology (IF=24.094)’, a world-renowned academic journal. and drew the attention of the international academic community.