Abstract

Aim. The purpose of this study was to determine factors influencing the time interval from the onset of clinical symptoms to thrombolytic infusion in patients with acute myocardial infarction

Background.Acute myocardial infarction is one of the most common causes of death and disability all over the world including Iran. The major cause of myocardial infarction, is the clot of blood in the coronary atherosclerotic plaques. Immediate administration of thrombolytic therapy in these patients can be life-saving.

Method. This study was a cross-sectional descriptive-analytical study in which 98 patients with acute myocardial infarction hospitalized in selected Rasht therapeutic centers were recruited by convenience sampling in 2014.Data collection instrument included demographic information form and researcher-made questionnaire to obtain patients' clinical, situational and cognitive factors. Data were collected through patients medical records and interview. Data were analyzed in SPSS version 21 using non-parametric Mann-Whitney and Kruskal Wallis tests and P<0.05 was considered as significant.

Findings. The mean time interval from the onset of symptoms to the beginning of thrombolytic infusion was 247.2±182.4 minutes.In this study, the most pre-hospital delay was related to making decision for care seeking and in-hospital delay time was the least one. The patients had delay in referring to the hospital mainly due to the following: negative history of previous heart disease) p=0.001), lack of awareness about the signs and symptoms of the disease )p<0.0001), female gender) p=0.026 ,(an underlying diabetes )p= 0.001),low levels of education (p=0.003), low income )p=0.044),mild pain )p=0.001), and self-medication )p=0.003).The main cause for delay was related to the lack of awareness of the symptoms and ignorance of their importance.

Conclusion. The time interval from the onset of symptoms to thrombolytic infusion in patients with acute myocardial infarction was not satisfactory. It is necessary to provide required training programs for increasing the individuals’ awareness about the symptoms of the disease and the importance of treatment with thrombolytic drugs, as soon as possible, in order to minimize the time delay, thereby, increasing the efficiency of treatment, and ultimately reducing the mortality and disability of patients.