Got chest pain? Call an ambulance and get to the hospital. If you are having the most dangerous type of heart attack - called a STEMI - you'll get faster treatment if you haven't been dealing with the pain for hours. That's the conclusion of a study from Dr. Henry Ting and his colleagues at the Mayo Clinic in Minnesota. The doctors crunched data on more than 440,000 patients in the National Registry of Myocardial Infarction from 1995 to 2004. Ting said the longer people waited before going to the hospital, the longer it took them to get treated after arrival. This was surprising, as you might expect hospitals to hustle with patients who have been suffering from symptoms - and therefore, potential heart damage - for hours. Ting remarked, "Maybe we should be telling our patients to tell [emergency room doctors that] they’ve only had an hour of chest pain so they get faster care."
Ting presented the data Monday at the American Heart Association meeting in Orlando.
His analysis showed that patients who arrived at the hospital no more than two hours after their pain started had the speediest treatment, getting "reperfusion therapy" within 33 to 99 minutes. The term refers to opening the blocked artery by either angioplasty or medication.
As patients reported longer and longer periods of pre-hospital pain, their time to treatment lagged. For example, patients who had symptoms for five to six hours beforehand got angioplasty within 112 minutes. Those with pain for more than 11 hours - about 123 minutes.
Ting posed some questions for future research: Why do patients with one to two hours of chest pain receive faster and better treatment than those who present with three to four hours of chest pain? Who are the patient subgroups at greatest risk for longer delays? What interventions may decrease delays to hospital presentation and who should we target?
As you might expect, the mortality rates for patients increased with the time delay for getting to the hospital. About 4 percent of patients who arrived at the hospital within two hours died, compared to about 7 percent of those arriving 11 hours after onset.
