Association of gender on the time of first medical contact primary pci activation for stemi patients at emergency department

Abstract

Background: Time between arrival at the Emergency Department (ED) and STEMI activation is a good indicator of the ED quality. Times of attention are of particular importance in some STEMI subgroups, such as elderly. Elderly patients are underdiagnosed and inadequately treated, resulting in a worse prognosis and survival rate. Aim: To determine association of age with the activation time in STEMI patients admitted to ED. Methods: An observational retrospective study was conducted including all patients admitted to the ED activated as a STEMI between 2013 and 2016. The main variable was the activation time, defined as the time between ED arrival and primary PCI activation. Results: A total of 330 patients were included. They were classified by age: 51.1% (167) <65 years old and 48.9% (160) ≥65 yo. Elderly patients exhibited more atypical symptoms and ECG changes as compared to younger. Being elderly (p=0.003) and having had medical contact prior to going to the ED (p=0.015) were associated with a longer activation time. Women older than 65 years old showed the longest activation time. Conclusion: STEMI delays are longer in elderly with atypical presentation. Age ≥65 and first medical contact outside the ED were associated with an increase in the activation time. This highlights the need to develop strategies to improve STEMI activation time for elderly.