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http://dx.doi.org/10.4040/jkan.2009.39.6.888

Comparison of Clinical Manifestations and Treatment-Seeking Behavior in Younger and Older Patients with First-time Acute Coronary Syndrome  

Hwang, Seon-Young (Department of Nursing, Chosun University)
Publication Information
Journal of Korean Academy of Nursing / v.39, no.6, 2009 , pp. 888-898 More about this Journal
Abstract
Purpose: This study was conducted to examine and compare clinical manifestations and predicting factors for treatment-seeking delay among patients <65 and ${\geq}65\;yr$ with first-time acute coronary syndrome (ACS). Methods: A total of 288 patients who were diagnosed with ACS were individually interviewed at C university hospital in G-city from November 2007 to December 2008. Results: Median pre-hospital delays for younger and older patients were 5 and 12 hr, respectively. Younger patients were more likely to be current smokers, heavy drinkers, obese, stressed, and have an unhealthy diet and family history, and to complain of chest pain, left shoulder and arm pain, perspiration, and nausea. Older patients were more likely to have hypertension and diabetes, and to complain syncope and dyspnea. Logistic regression analyses showed that after adjustment for age, gender and education, progressive onset of symptom and no attribution to cardiac problem significantly predicted pre-hospital delay >3 hr in both younger and older patients. Low perceived health status was a significant independent predictor in older patients only. Conclusion: Health care providers should be concerned with different manifestations between younger and older adults, and educate people at risk for heart attack about symptoms and actions to get immediate help.
Keywords
Acute coronary syndrome; Acute myocardial infarction; Health care seeking behavior;
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1 Berger, P. B., Ellis, S. G., Holmes, D. R. Jr, Granger, C. B., Criger, D. A., Betriu, A., et al. (1999). Relationship between delay in performing direct coronary angioplasty and early clinical outcome in patients with acute myocardial infarction: Results from the global use of strategies to open occluded arteries in acute coronary syndromes (GUSTO-IIb) trial. Circulation, 100, 14-20   DOI   PUBMED   ScienceOn
2 Eom, W. S., Kim, D. K., Kim, Y. J., Ryu, J. S., Cho, J. H., Joo, S. B., et al. (2003). The first symptoms and diagnosis of acute coronary syndrome in elderly patients of Korea. Geriatric Disease, 7, 313-320
3 Jeong, M. H., Kim, Y. J., Kim, C. J., Cho, M. C., An, Y. K., Na, S. W., et al. (2007). Korean acute myocardial infarction registry. Korean Circulation Journal, Supplement, 37(10), 3-18
4 Korea National Health Insurance Corporation. (2007, December). National health insurance statistical yearbook 2006. Seoul: Author
5 Korea National Statistical Office. (2007, December 1). Classification of disease and causes of death 2007. Retrieved October 8, 2008, from http://Kosis.kr
6 Thuresson, M., Berglin, M., Lindahl, B., Svensson, L., Zedigh, C., & Herlitz, J. (2007). Thoughts, actions, and factors associated with prehospital delay in patients with acute coronary syndrome. Heart &Lung, 36, 398-409   DOI   ScienceOn
7 Goldberg, R. J., Mooradd, M., Gurwitz, J. H., Rogers, W. J., French, W. J., Barron, H. V., et al. (1998). Impact of time to treatment with tissue plasminogen activator on morbidity and mortality following acute myocardial infarction (the second National Registry of Myocardial Infarction). American Journal of Cardiology, 82, 259-264   DOI   ScienceOn
8 Canto, J. G., Shlipak, M. G., Rogers, W. J., Malmgren, J. A., Frederick, P. D., Lambrew, C. T., et al. (2000). Prevalence, clinical characteristics, and mortality among patients with myocardial infarction presenting without chest pain. JAMA, 283, 3223- 3229   DOI   ScienceOn
9 Milner, K. A., Funk, M., Richards, S., Vacarrino, V., & Krumholz, H. M. (2001). Symptom predictors of acute coronary syndromes in younger and older patients. Nursing Research, 50, 233-241   DOI   ScienceOn
10 Zerwic, J. J. (1999). Patient delay in seeking treatment for acute myocardial infarction symptoms. Journal of Cardiovascular Nursing, 13, 21-32   PUBMED
11 Schuler, J., Meier, B., Behrens, S., & Thimme, W. (2006). Present treatment of acute myocardial infarction in patients over 75 years, data from the Berlin myocardial infarction registry. Clinical Research in Cardiology, 95, 360-367   DOI   ScienceOn
12 Antman, E. M., Anbe, D. T., Armstrong, P. W., Bates, E. R., Green, L. A., Hand, M., et al. (2005). ACC/AHA guidelines for the management of patients with ST-elevation myocardial infarction:A report of the American College of Cardiology/American Heart Association task force on practice guidelines (Committee to revise the 1999 guidelines for the management of patients with acute myocardial infarction). Circulation, 111, 2013-2014
13 Ottesen, M. M., Kober, L., Jorgensen, S., & Torp-Pedersen, C. (1996). Determinants of delay between symptoms and hospital admission in 5,978 patients with acute myocardial infarction. European Heart Journal, 17, 429-437   DOI   PUBMED   ScienceOn
14 Franklin, K., Goldberg, R. J., Spencer, F., Klein, W., Budaj, A., Brieger, D., et al. (2004). Implications of diabetes in patients with acute coronary syndromes. Archives of Internal Medicine, 164, 1457-1463   DOI   ScienceOn
15 Lovlien, M., Schei, B., & Hole, T. (2007). Prehospital delay, contributing aspects and responses to symptoms among Norwegian women and men with first time acute myocardial infarction. European Journal of Cardiovascular Nursing, 6, 308-313   DOI   ScienceOn
16 Oh, H. S., Jang, K. S., & Jeong, M. H. (2008). Decision tree model of treatment-seeking delay among patients with acute coronary syndrome. Korean Journal of Health Promotion and Disease Prevention, 8, 235-244   ScienceOn
17 Arslanian-Engoren, C., Patel, A., Fang, J., Armstrong, D., Kline-Rogers, E., Duvernoy, C. S., et al. (2006). Symptoms of men and women presenting with acute coronary syndromes. American Journal of Cardiology, 98, 1177-1181   DOI   ScienceOn
18 Brieger, D., Eagle, K. A., Goodman, S. G., Steg, P. G., Budaj, A., White, K., et al. (2004). Acute coronary syndromes without chest pain, an underdiagnosed and under treated high-risk group: Insights from the global registry of acute coronary events. Chest, 126, 461-469   DOI   ScienceOn
19 Dracup, K., & Moser, D. K. (1997). Beyond sociodemographics: Factors influencing the decision to seek treatment for symptoms of acute myocardial infarction. Heart & Lung, 26, 253-262   DOI   ScienceOn
20 An, K. E., & Koh, B. G. (2003). Pre-and in-hospital delay in treatment and in-hospital mortality after acute myocardial infarction. Journal of Korean Academy of Nursing, 33, 1153-1160   과학기술학회마을   ScienceOn
21 Hwang, S. Y., Park, E. H., Shin, E. S., & Jeong, M. H. (2009). Comparison of factors associated with atypical symptoms among older and younger patients with acute coronary syndromes. Journal of Korean Medical Science, 24, 789-794   DOI   ScienceOn
22 Song, Y. B., Hahn, J. Y., Gwon, H. C., Kim, J. H., Lee, S. H., Jeong, M. H., et al. (2008). The impact of initial treatment delay using primary angioplasty on mortality among patients with acute myocardial infarction: From the Korea acute myocardial infarction registry. Journal of Korean Medical Science, 23, 357-364   DOI   ScienceOn
23 Tespili, M., Guagliumi, G., Valsecchi, O., Musumeci, G., Vassileva, A., Saino, A., et al. (2003). In-hospital clinical outcome in elderly patients with acute myocardial infarction treated with primary angioplasty. Italian Heart Journal, 4, 193-198   ScienceOn
24 Moser, D. K., Kimble, L. P., Alberts, M. J., Alonzo, A., Croft, J. B., Dracup, K., et al. (2006). Reducing delay in seeking treatment by patients with acute coronary syndrome and stroke: A scientific statement from the American Heart Association Council on cardiovascular nursing and stroke council. Circulation, 114, 168-182   DOI   ScienceOn
25 Dracup, K., Moser, D. K., McKinley, S., Ball, C., Yamasaki, K., Kim, C. J., et al. (2003). An international perspective on the time to treatment for acute myocardial infarction. Journal of Nursing Scholarship, 35, 317-323   DOI
26 Gregoratos, G. (2001). Clinical manifestations of acute myocardial infarction in older patients. American Journal of Geriatric Cardiology, 10, 345-347   DOI   PUBMED   ScienceOn
27 Goldberg, R. J., Steg, P. G., Sadiq, I., Granger, C. B., Jackson, E. A., Budaj, A., et al. (2002). Extent of, and factors associated with, delay to hospital presentation in patients with acute coronary disease (the GRACE registry). American Journal of Cardiology, 89, 791-796   DOI   ScienceOn
28 Moser, D. K., & An, K. A. (2002). Responses to symptoms of acute myocardial infarction: Reasons for delay and bystanders' role. Journal of Korean Academy of Nursing, 32, 1063-1071