ABSTRACT
The high mortality rate of myocardial infarction [MI] before admission to hospital, particularly at younger ages, is a major health challenge. In fact 90% of deaths among patients < 55 years occur before arrival at hospital. This study sought to examine the association between methods of transfer with MI-related outcomes. The study was conducted among patients admitted to Taleghani Teaching Hospital [Urmia, Iran] with chest pain and symptoms of early MI. These patients were studied for endpoints including treatment [thrombolytic] and survival. Information was collected using a previously developed and validated questionnaire. Data analysis was performed by examining frequency, means and standard deviations for a range of variables. We estimated the association between method of transfer and outcome using paired t-test and one way ANOVA. Among 274 eligible patients with admissions for MI, 41 [15%] were transferred by ambulances using emergency telephone hotlines while the remainder used alternative means. Among those not using ambulance services, 143 were not aware of the existence of those services and 76 did not believe they were experiencing MI. 48.5% of all patients received thrombolytic [streptokinase] therapy. Patients arriving by ambulance were significantly more likely to receive thrombolytic therapy than other patients [p-value =0.001], although there was no significant difference in mortality between the groups [p-value =0.88]. This hospital-based study from Iran has identified lack of knowledge about emergency ambulance services as well as lack of awareness about symptoms of heart attack to be major barriers to using available facilities