Effect of delay time on in-hospital mortality in a Hispanic Population hospitalized with acute myocardial infarction. The Puerto Rico Cardiovascular Surveillance Study: 2007, 2009 and 2011.

J Vajta, R. Zevallos, JC Zevallos, JM Lozano


Introduction: In the United States, heart disease is the leading cause of death for both men and women. One of the main categories of heart disease is acute myocardial infarction (AMI), which is responsible for 1.5 million events per year. Data show that longer delay time to treatment limit the beneficial use of thrombolytic therapy with optimal use during the first hour after symptom onset. The purpose of this study is identify if an association exists between delay time and in-hospital mortality and to explore which factors impact delay time to treatment in a Hispanic population of Puerto Rico hospitalized with AMI. Methods: Study Design: A non-concurrent prospective design was conducted using a secondary analysis of the Puerto Rico Cardiovascular Surveillance Study. Data were abstracted from the medical charts of 21 health care facilities using International Classification of Diseases, 9th Revision (ICD-9) codes 410-41. Each case was validated according to the World Health Organization (WHO) criteria for AMI. Only patients with incidental AMI and adults > 18 years of age were included. Variables: Dependent variable is in-hospital mortality and independent variables are delay time, demographics, transportation mode, teaching hospital, angina, coronary artery bypass grafting, congestive heart failure, diabetes, hyperlipidemia, hypertension, current smoker and stroke. Analysis: Distribution of categorical variables were expressed in frequencies of percent and associations were analyzed via X2 test. Distribution of numerical variables were expressed as the Mean (Standard Deviation) and associations were analyzed via ANOVA and t-test. Binomial logistic regression was used to test for the unadjusted and adjusted association between delay time and mortality. Statistical analysis was conducted utilizing SPSS software, and statistical significance was defined as p<0.05.

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