Half of coronary patients are not instructed how to respond to symptoms of a heart attack

Background: The delayed treatment of acute coronary syndrome has a significant impact on survival. Due to improved organization and the use of reperfusion therapies, inhospital delay has been shortened in recent years. However, the time between the onset of chest pain and the call for medical help is still too long. The aim of this study was to assess the proportion of coronary patients instructed how to behave in case of chest pain and to find what factors relate to a lower probability of being counselled. Methods: Patients aged < 80 years, hospitalized due to coronary artery disease (CAD) were identified retrospectively on the basis of a medical records review and were invited for a follow-up examination. Two hundred and nineteen patients agreed to participate in the study. Data on the prehospital delay was obtained using a standard questionnaire. Results: The study group consisted of 149 men and 70 women. The mean time between discharge and the follow-up examination was 1.1 &#177; 0.4 years. Of 219 study participants, 106 (48.4%) declared they had been instructed about the symptoms of a heart attack and how to respond to it. Men, smokers, non-diabetics, and those with previously diagnosed CAD had been instructed more frequently. The independent predictors of being instructed were: percutaneous coronary intervention during the index hospitalization, diabetes, smoking, male sex and previously diagnosed CAD. Conclusions: About half of patients after hospitalization due to CAD are not instructed how to respond to heart attack symptoms. This has not changed over the last decade and may contribute to the lack of shortening of prehospital delay. (Cardiol J 2011; 18, 6: 668&#8211;674