[Factors leading to delay in decision to seek treatment in patients with acute myocardial infarction in Beijing].

Objective: To investigate the factors associated with delay in decision to seek treatment in patients with acute myocardial infarction (AMI) in Beijing.

Methods: This prospective, cross-sectional, multicenter survey was conducted from November 1, 2005 and December 31 ,2006. The participants consisted of 799 patients with STEMI admitted within 24 h of symptom onset to 19 hospitals in Beijing. Data were collected by semi-structured interviews and medical records review. The patients were categorized into an early decision group and the a late decision group based on the 30 min cut-off.

Results: The median (25%, 75%) decision delay in STEMI patients was 60 (20, 180) min. Factors associated with late decision in an univariate analysis were age > or = 65 years, retirement or unemployment, history of myocardial infarction, symptom onset at home and intermittent symptoms, whereas presence of bystanders such as friends, coworkers or even strangers, unbearable symptoms, dyspnea, sweating, syncope and attribution of symptoms to cardiac origin were related to early decision. Multivariate logistic analysis showed that history of myocardial infarction, absence of syncope, intermittent symptoms, bearable symptoms and attribution of symptoms to noncardiac origin were independent predictors of decision delay > 30 min. Patients in the early decision group had more chances to receive acute reperfusion therapies (P = 0.001) and shorter time intervals from symptom onset to reperfusion therapies (P <0.001).

Conclusions: To a great extent patients with AMI in Beijing delayed in decision to seek treatment. History of myocardial infarction, symptom characteristics and symptom attribution were associated with decision delay.