Media release Call for greater awareness of need for early heart treatment new study Many people

e with acute coronary syndrome delay going to hospital until too late to benefit from treatment. This is the finding of a study published online as an Early View article in Emergency Medicine Australasia, the journal of the Australasian College for Emergency Medicine. Professor Sharon McKinley, professor of critical care nursing at University of Technology Sydney Royal North Shore Hospital, and her colleagues studied prospectively 140 patients in Australia and New Zealand who already had known coronary artery disease which had previously resulted in heart attack or angina or they had undergone a reperfusion procedure. The median delay from onset of symptoms to presentation at hospital was two and a half hours, the researchers found. The average age of patients in the study was 67 years, and most (64%) were male. Coronary artery disease continues to be a significant cause of death and disability in the developed world, the researchers said. In the 20042005 Australian National Health Survey, 354,700 people reported that they had had a heart attack; about 47,730 major coronary events are estimated to have occurred in 2005 in 40- to 90-year-olds, a rate of about 130 per day. Approximately 40% of events (19,430 cases) were fatal. Professor McKinley and her colleagues said only 12% of patients in their study who had a confirmed diagnosis of acute coronary syndrome had arrived at hospital within one hour of recognizing the onset of their symptoms. A similar percentage arrived more than 12 hours after symptom onset when the possibility of benefit from reperfusion treatments is remote. These findings reinforce the continuing need to address the problem of delays in deciding to seek treatment after recognition of acute coronary syndrome symptoms, as well as recognition of symptoms as possible acute coronary syndrome. Those who used an ambulance to go to hospital had a delay time 30% shorter than those who drove or walked to hospital. Previous Australian research has shown that many patients experiencing chest pain perceived that they were not seriously ill enough to justify activation of an emergency response by an ambulance, and many who

travelled by ambulance did so because their GP called the ambulance, although those who saw their GP first were more likely to have delayed presentation. Professor McKinley and her colleagues are calling for increased education and greater awareness of the benefits of early hospital treatment for acute coronary syndrome. As with all people with acute coronary syndrome symptoms, older people with coronary heart disease who are at greater risk for acute coronary syndrome than the general population need to understand that the most appropriate response is to call an ambulance to take them to hospital as quickly as possible. However, it seems likely that older people with coronary artery disease especially need to be assisted in recognizing the symptoms of possible acute coronary syndrome as a first step to seeking treatment.

FURTHER INFORMATION: Professor Sharon McKinley Phone 02 9926 8281

Australasian College for Emergency Medicine, phone 03 9320 0444 Issued for the Australasian College for Emergency Medicine by Marilyn Bitomsky, Impact Promotions & Publications, phone 07 3371 3057 or 0412 884 114.