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Résumé :
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ObjectiveWe aimed to assess whether patients’ knowledge about acute myocardial infarction (AMI) has an impact on the prehospital delay-time.MethodsThis investigation was based on 486 AMI patients who participated in the cross-sectional Munich-Examination-of-Delay-in-Patients-Experiencing-Acute-Myocardial-Infarction (MEDEA) study. A modified German-version of the ACS-Response-Index Questionnaire was used. Multivariate logistic-regression models were used to identify factors associated with knowledge-level as well as the impact of knowledge-level on delay-time.ResultsHigh AMI-knowledge shortened median delay-time in men (168[92–509] vs. 276[117–1519] mins, p = 0.0069), and in women (189[101–601] vs. 262[107–951]mins, p = 0.34). Almost half-of-patients (n = 284,58%) demonstrated high AMI-knowledge. High-knowledge were independently associated with male-gender (OR = 1.47[1.17–1.85]) and General-Practitioner as a knowledge-source (OR = 1.42[1.14–1.77]). Old-age (OR = 0.87[0.86–0.89]) and previous AMI-history/stent-placement (OR = 0.65[0.46–0.93]) were significantly associated with lower-knowledge. Although the majority (476,98%) correctly recognized at least one AMI-symptom, 69(14.2%) patients correctly identified all AMI-symptoms. Additionally, one-in-three believed that heart-attack is always accompanied with severe chest-pain. Elderly-patients and women were more likely to be less-knowledgeable about atypical-symptoms (p = 0.006), present with atypical AMI-presentation (p < 0.001) and subsequently experience protracted delay-times (p < 0.001).ConclusionsKnowledge of AMI-symptoms remains to be substandard, especially knowledge of atypical-symptoms. Knowledge is essential to reduce delay-times, but it is not a panacea, since it is not sufficient alone to optimize prehospital delay-times.
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