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Ookeditse O, Ookeditse KK, Motswakadikgwa TR, Masilo G, Bogatsu Y, Lekobe BC, Mosepele M, Schirmer H, Johnsen SH. Age and healthy lifestyle behavior's disparities and similarities on knowledge of myocardial infarction symptoms and risk factors among public and outpatients in a resource-limited setting, cross-sectional study in greater Gaborone, Botswana. BMC Cardiovasc Disord 2024; 24:140. [PMID: 38439021 PMCID: PMC10910839 DOI: 10.1186/s12872-024-03792-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/08/2023] [Accepted: 02/15/2024] [Indexed: 03/06/2024] Open
Abstract
OBJECTIVES In this cross-sectional study from Botswana, we investigated knowledge of myocardial infarction (MI) symptoms and risk factors among the general public and outpatients with MI risk factors based on age and lifestyle behaviors, in addition to assessing associations with sociodemographic and MI risk factors. METHOD Open-ended questionnaires about 8 MI symptoms and 10 risk factors, were administered by research assistants to a representative selection of outpatients (n = 525) and the public (n = 2248). Weight and height were measured in all participants and BMI was calculated. Knowledge scores were compared between the two groups. We examined whether sociodemographic and MI risk factors had impact on the scores. Analyses were further adjusted for lifestyle behavior (smoking status, dietary status and physical activities). RESULTS The valid response rate was 97.9% comprising 97.8% for the public (n = 2199) and 98.1% for outpatients (n = 515). Public respondents (35.2 ± 12.3 years) were younger than outpatients (38.5 ± 12.6 years). The public comprised 56.9% females while outpatients 54.6%. In general, outpatients had higher knowledge of MI symptoms than the public, with mean scores ± SD of 3.49 ± 2.84 vs 2.80 ± 2.54. Outpatients also had higher knowledge score of MI risk factors than the public, with mean scores, 5.33 ± 3.22 vs 3.82 ± 3.07. For MI symptoms, outpatients were more aware than the public for chest pains among all ages, for arm pain/ numbness, neck/ jaw pain radiating to/ from chest, and feeling sick or looking pallor on the skin among those aged 35-49 years. Among both the public and outpatients, lower knowledge of both MI symptoms and risk factors was associated with primary education, not residing/working together, history of hypertension, no history of heart disease/stroke, and obesity. There were similarities and disparities on MI knowledge among respondents with various numbers of healthy lifestyle behaviours. CONCLUSION Results call for urgent educational campaigns on awareness and knowledge of MI and using strategies based on age and lifestyle behavior.
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Affiliation(s)
- Ookeditse Ookeditse
- Department of Physical Medicine and Rehabilitation, Trust Hospital in Vestfold, Kysthospitalet, Division of Neurorehabilitation Medicine, Tønsberg, Norway
- Department of Family Medicine, Larvik County Acute and Emergency Clinic, Larvik, Norway
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | | | | | - Gosiame Masilo
- Department of Family Medicine, Larvik County Acute and Emergency Clinic, Larvik, Norway
- Division of Family Medicine, Nanset Medical Clinic, Larvik, Norway
| | - Yaone Bogatsu
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
| | - Baleufi C Lekobe
- Department of Internal Medicine, Sidilega Private Hospital, Gaborone, Botswana
| | - Mosepele Mosepele
- Faculty of Medicine, University of Botswana, Gaborone, Botswana
- Princess Marina Referral Hospital, Gaborone, Botswana
| | - Henrik Schirmer
- UIT The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway
- Department of Cardiology, Akershus University Hospital, Lørenskog, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Stein H Johnsen
- UIT The Arctic University of Norway, Institute of Clinical Medicine, Tromsø, Norway.
- Department of Neurology, University Hospital of North Norway, Tromsø, Norway.
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Gehin M, Storey RF, Bernaud C, Dingemanse J. Clinical pharmacology of selatogrel for self-administration by patients with suspected acute myocardial infarction. Expert Opin Drug Metab Toxicol 2023; 19:697-708. [PMID: 37795868 DOI: 10.1080/17425255.2023.2266384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2023] [Accepted: 09/29/2023] [Indexed: 10/06/2023]
Abstract
INTRODUCTION P2Y12 receptor antagonists (P2Y12 inhibitors) are well established for the treatment of coronary artery disease. The P2Y12 inhibitors currently commercially available present either pharmacokinetic limitations (due to delayed absorption, bioactivation requirement via CYP enzymes, or need of intravenous administration), pharmacodynamic (PD) limitations (limited % inhibition of platelet aggregation (IPA) or relevant PD interactions) or safety limitations (major bleeding in specific populations). AREAS COVERED Selatogrel, a 2-phenylpyrimidine-4-carboxamide analog, is a potent, reversible, and selective P2Y12 inhibitor administered subcutaneously that is under development for the treatment of acute myocardial infarction (AMI) in patients with a recent history of AMI. In this review, the authors summarize the results from preclinical, phase 1, and phase 2 trials which showed that selatogrel provides rapid, pronounced, and reversible P2Y12 receptor inhibition with a favorable safety profile. EXPERT OPINION These unique characteristics added to the limited potential to interact with co-medications and manageable PD interactions with other P2Y12 inhibitors provide a clear rationale for investigating the benefit of selatogrel as an emergency treatment to improve clinical outcomes in patients with AMI.
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Affiliation(s)
- Martine Gehin
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals, Allschwil, Switzerland
| | - Robert F Storey
- Division of Clinical Medicine, University of Sheffield, Sheffield, UK
- NIHR Sheffield Biomedical Research Centre, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, UK
| | - Corine Bernaud
- Department of Clinical Science, Idorsia Pharmaceuticals Ltd, Allschwil, Switzerland
| | - Jasper Dingemanse
- Department of Clinical Pharmacology, Idorsia Pharmaceuticals, Allschwil, Switzerland
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Møller AL, Rytgaard HCW, Mills EHA, Christensen HC, Blomberg SNF, Folke F, Kragholm KH, Lippert F, Gislason G, Køber L, Gerds TA, Torp-Pedersen C. Hypothetical interventions on emergency ambulance and prehospital acetylsalicylic acid administration in myocardial infarction patients presenting without chest pain. BMC Cardiovasc Disord 2022; 22:562. [PMID: 36550452 PMCID: PMC9783974 DOI: 10.1186/s12872-022-03000-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2022] [Accepted: 12/08/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Myocardial infarction (MI) patients presenting without chest pain are a diagnostic challenge. They receive suboptimal prehospital management and have high mortality. To elucidate potential benefits of improved management, we analysed expected outcome among non-chest pain MI patients if hypothetically they (1) received emergency ambulances/acetylsalicylic acid (ASA) as often as observed for chest pain patients, and (2) all received emergency ambulance/ASA. METHODS We sampled calls to emergency and non-emergency medical services for patients hospitalized with MI within 24 h and categorized calls as chest pain/non-chest pain. Outcomes were 30-day mortality and a 1-year combined outcome of re-infarction, heart failure admission, and mortality. Targeted minimum loss-based estimation was used for all statistical analyses. RESULTS Among 5418 calls regarding MI patients, 24% (1309) were recorded with non-chest pain. In total, 90% (3689/4109) of chest pain and 40% (525/1309) of non-chest pain patients received an emergency ambulance, and 73% (2668/3632) and 37% (192/518) of chest pain and non-chest pain patients received prehospital ASA. Providing ambulances to all non-chest pain patients was not associated with improved survival. Prehospital administration of ASA to all emergency ambulance transports of non-chest pain MI patients was expected to reduce 30-day mortality by 5.3% (CI 95%: [1.7%;9%]) from 12.8% to 7.4%. No significant reduction was found for the 1-year combined outcome (2.6% CI 95% [- 2.9%;8.1%]). In comparison, the observed 30-day mortality was 3% among ambulance-transported chest pain MI patients. CONCLUSIONS Our study found large differences in the prehospital management of MI patients with and without chest pain. Improved prehospital ASA administration to non-chest pain MI patients could possibly reduce 30-day mortality, but long-term effects appear limited. Non-chest pain MI patients are difficult to identify prehospital and possible unintended effects of ASA might outweigh the potential benefits of improving the prehospital management. Future research should investigate ways to improve the prehospital recognition of MI in the absence of chest pain.
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Affiliation(s)
- Amalie Lykkemark Møller
- grid.414092.a0000 0004 0626 2116Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark
| | - Helene Charlotte Wiese Rytgaard
- grid.5254.60000 0001 0674 042XSection of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | | | - Helle Collatz Christensen
- grid.415046.20000 0004 0646 8261Danish Clinical Quality Program (RKKP), National Clinical Registries, Frederiksberg Hospital, Frederiksberg, Denmark ,grid.512919.7Copenhagen Emergency Medical Services, Ballerup, Denmark
| | | | - Fredrik Folke
- grid.512919.7Copenhagen Emergency Medical Services, Ballerup, Denmark ,grid.4973.90000 0004 0646 7373Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Kristian Hay Kragholm
- grid.27530.330000 0004 0646 7349Unit of Clinical Biostatistics and Epidemiology, Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
| | - Freddy Lippert
- grid.512919.7Copenhagen Emergency Medical Services, Ballerup, Denmark ,grid.5254.60000 0001 0674 042XDepartment of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Gunnar Gislason
- grid.4973.90000 0004 0646 7373Department of Cardiology, Copenhagen University Hospital Herlev and Gentofte, Hellerup, Denmark ,grid.453951.f0000 0004 0646 9598Department of Research, Danish Heart Foundation, Copenhagen, Denmark ,grid.10825.3e0000 0001 0728 0170The National Institute of Public Health, University of Southern Denmark, Copenhagen, Denmark
| | - Lars Køber
- grid.475435.4Department of Cardiology, Rigshospitalet Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Alexander Gerds
- grid.5254.60000 0001 0674 042XSection of Biostatistics, Department of Public Health, University of Copenhagen, Copenhagen, Denmark
| | - Christian Torp-Pedersen
- grid.414092.a0000 0004 0626 2116Department of Cardiology, Nordsjællands Hospital, Hillerød, Denmark ,grid.27530.330000 0004 0646 7349Department of Cardiology, Aalborg University Hospital, Aalborg, Denmark
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Gender and Social Inequalities in Awareness of Coronary Artery Disease in European Countries. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031388. [PMID: 35162415 PMCID: PMC8835179 DOI: 10.3390/ijerph19031388] [Citation(s) in RCA: 10] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Revised: 01/19/2022] [Accepted: 01/20/2022] [Indexed: 12/13/2022]
Abstract
Coronary artery disease (CAD) is the single leading cause of death in Europe and the most common form of cardiovascular disease. Little is known about awareness in the European population. A cross-sectional telephone survey of 2609 individuals from six European countries was conducted to gather information on perceptions of CAD, risk factors, preventive measures, knowledge of heart attack symptoms and ability to seek emergency medical care. Level of awareness was compared according to gender, age, socioeconomic status (SES) and educational level. Women were approximately five times less likely than men to consider heart disease as a main health issue or leading cause of death (OR = 0.224, 95% CI: 0.178–0.280, OR = 0.196, 95% CI: 0.171–0.226). Additionally, women were significantly less likely to have ever had a cardiovascular screening test (OR = 0.515, 95% CI: 0.459–0.578). Only 16.3% of men and 15.3% of women were able to spontaneously identify the main symptoms of a heart attack. Almost half of the sample failed to state that they would call emergency services in case of a cardiac event. Significant differences according to age, SES and education were found for many indicators amongst both men and women. Development of a European strategy targeting improved awareness of CAD and reduced gender and social inequalities within the European population is warranted.
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Basham K, Aldubaikhi A, Sulaiman I, Alhaider A, Alrasheed A, Bahanan F, Masuadi E, Alsaif A. Public awareness of early symptoms of acute myocardial infarction among Saudi population. J Family Med Prim Care 2021; 10:3785-3790. [PMID: 34934681 PMCID: PMC8653441 DOI: 10.4103/jfmpc.jfmpc_449_21] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2021] [Revised: 07/05/2021] [Accepted: 07/18/2021] [Indexed: 01/16/2023] Open
Abstract
Introduction: Globally speaking, cardiovascular disease is the leading cause of mortality, with coronary artery disease (CAD) contributing to half of the cases. A major complication of CAD is myocardial infarction (MI). The clinical outcomes of MI are predominantly time-dependent; therefore, it is paramount that the general public is familiar with the early symptoms of MI. Aim: The main objective is to gauge the local public awareness of the early symptoms of MI, and their knowledge of the best course of action to be taken from the onset of symptoms. Method: A cross-sectional study was conducted using google forms. Participants were randomly selected through multiple social media platforms. The study included Saudi citizens who were 18 years or older, with no current or prior experience in the health care field. The questionnaire assessed the participants' awareness of 14 risk factors for CAD. The variables investigated were participants' knowledge of the symptoms, causes, appropriate course of action to be taken, and the risk factors of CAD. Results: A total of 1689 participants were involved in this study. Sixty percent were females, and 29.2% were in the age group of 18–24 years. Seventy-three percent of the participants knew the definition of heart attack, and 90% knew that chest pain is a symptom of a heart attack. Approximately, 75% of the participants recognized that hypertension, cigarette smoking, and high cholesterol are the risk factors of MI. In terms of knowledge, Al Madinah province obtained the highest score when compared with other regions. Conclusion: This study showed the overall knowledge and awareness of CAD was suboptimal, indicating that awareness initiatives and patient education of CAD need more work in Saudi Arabia, especially in high-risk groups and lower education groups. More studies are needed to identify the efficiency and population access of different approaches for CAD awareness.
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Affiliation(s)
- Karam Basham
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Aldubaikhi
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ihab Sulaiman
- Consultant, Department of Adult Cardiology and Advanced Cardiac Imaging, King Abdulaziz Cardiac Center, King Abdulaziz Medical City, Riyadh, Saudi Arabia
| | - Abdullah Alhaider
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Ahmed Alrasheed
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Fahad Bahanan
- College of Medicine, King Saud Bin Abdulaziz University for Health Sciences, Riyadh, Saudi Arabia
| | - Emad Masuadi
- Department of Medical Education, Research Unit, College of Medicine, Riyadh, King Saud Bin Abdul-Aziz University for Health Sciences, Riyadh, Saudi Arabia
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Burton S, Hayes JA, Morrell-Scott N, Sanders J, Walthall H, Wright DJ, Jones ID. Should I stay or should I go? An exploration of the decision-making behavior of acute cardiac patients during the COVID-19 pandemic. Heart Lung 2021; 52:16-21. [PMID: 34823051 PMCID: PMC8606948 DOI: 10.1016/j.hrtlng.2021.07.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2021] [Revised: 07/23/2021] [Accepted: 07/25/2021] [Indexed: 11/10/2022]
Abstract
Background During the SARS-COV-2 (COVID-19) pandemic efforts to reduce virus transmission resulted in non-emergency patients being deterred from seeking help. The number of patients presenting with acute cardiac conditions reduced, significantly Objectives To explore the decision-making process, and influential factors in that process, of patients and their family during an acute cardiac event. Methods A qualitative research design was employed using purposive sampling of patients who experienced an acute cardiac event during the social containment mandates. Semi-structured interviews were conducted, with thematic analysis of interview transcripts. Results Twenty-five participants were recruited from three UK hospitals. Themes identified were reliance on informal support network, lack of awareness of cardiac symptoms leading to delayed help-seeking, and an indirect COVID-19 effect (e.g. avoiding treatment). Conclusions These results highlight the need for informed public health messages, targeting patients and their support networks, that allow those in need of treatment to access care.
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Affiliation(s)
- S Burton
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom
| | - J A Hayes
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom
| | - N Morrell-Scott
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom
| | - J Sanders
- Barts Health NHS Trust William Harvey Research Institute, St Bartholomew's Hospital, Queen Mary University of London, United Kingdom
| | - H Walthall
- Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, United Kingdom
| | - D J Wright
- Liverpool Heart and Chest Hospital, Liverpool, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom
| | - I D Jones
- School of Nursing and Allied Health, Faculty of Health, Liverpool John Moores University, Tithebarn Building, Liverpool L2 2ER, United Kingdom; Liverpool Centre for Cardiovascular Science, United Kingdom.
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Sharma A, Vidusha K, Suresh H, M J A, Saravanan K, Dhamania M, B N, Wani RT. Global Awareness of Myocardial Infarction Symptoms in General Population: a Systematic Review and Meta-Analysis. Korean Circ J 2021; 51:983-996. [PMID: 34595883 PMCID: PMC8636754 DOI: 10.4070/kcj.2021.0100] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 07/18/2021] [Accepted: 08/11/2021] [Indexed: 11/23/2022] Open
Abstract
Seventy percent people are able to recognize chest pain as myocardial infarction (MI) symptoms. There is no difference in awareness of MI symptoms between male and female. There is wide variation in awareness of MI symptoms. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and in Asian countries such as Nepal to as high as 90% in Germany. Background and Objectives Knowledge about myocardial Infarction (MI) symptoms is crucial because inadequate awareness ensures direct association with patient delay and adverse health events subsequently. Methods PRISMA guidelines were followed while conducting the systematic review with PROSPERO number CRD42020219802. An electronic search was conducted comprehensively through 5 databases to find those relevant articles systematically. Prevalence was calculated for each typical symptom of MI separately and subgroup analysis according to continent, country, gender and ethnicity was done. Meta-Analysis was conducted by using statistical software R version 3.4.3. A random-effects model was used. Results Studies from 35 different countries with 120,988,548 individuals were included in the final analysis. The prevalence of chest pain awareness was highest, while it was lowest for jaw, back, and neck pain. There was no difference in terms of awareness in males and females. Prevalence of awareness of typical MI symptoms was higher in the Caucasian white, white, and non-Hispanic white groups than in other groups. The prevalence varies from less than 5% in African countries such as Kenya, Tanzania and Asian countries such as Nepal to as high as 90% in Germany. Conclusions People are well aware of chest pain as a symptom of MI. However, there is limited knowledge regarding other typical symptoms of MI.
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Affiliation(s)
- Akash Sharma
- Rush University Medical Center, Chicago, IL, USA.
| | - Karavadi Vidusha
- Department of Community Medicine, Rajarajeswari Medical College and Hospital, Bangalore, Karnataka, India
| | - Harshini Suresh
- Department of Community Medicine, Mysore Medical College & Research Institute, Mysuru, Karnataka, India
| | - Ajan M J
- Directorate of Health Services, Thiruvananthapuram, Kerala, India
| | - Kavinkumar Saravanan
- Department of Community Medicine, Government Medical College and Hospital, Nagpur, Maharashtra, India
| | - Madhvi Dhamania
- Department of Community Medicine, SMS Medical College, Jaipur, Rajasthan, India
| | - Nisha B
- Department of Community Medicine, Saveetha Medical College & Hospital, Chennai, Tamil Nadu, India
| | - Rabbanie Tariq Wani
- Department of Community Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
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Abdo Ahmed AA, Mohammed Al-Shami A, Jamshed S, Fata Nahas AR, Mohamed Ibrahim MI. Public Awareness of and Action towards Heart Attack Symptoms: An Exploratory Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17238982. [PMID: 33276636 PMCID: PMC7729488 DOI: 10.3390/ijerph17238982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 05/15/2020] [Revised: 06/27/2020] [Accepted: 07/03/2020] [Indexed: 11/16/2022]
Abstract
Background: Cardiovascular disease (CVD) is still the leading cause of mortality worldwide, and Malaysia is not an exception in this regard. The current research is an attempt to explore symptom awareness of and necessary actions in response to heart attack (HA) among lay public. Methods: This is a cross-sectional study design, and a survey was conducted from May to July 2018 among general public in Kuantan, Pahang state, Malaysia. Results: A total of 393 respondents recruited. Slightly more than one-fourth of the respondents (26.35%) were aware of HA symptoms like pain and/or discomfort in the jaw, neck, or back, while 71.65% showed awareness only of chest pain or discomfort as symptoms. Only 35.6% reported to call an ambulance if they experience someone suffering from HA symptoms, while 82% recognized ≥1 symptom, and only 11.5% recognized all five HA symptoms. Very few respondents, i.e., 1.3% reported awareness about correct recognition of all five HA symptoms. Respondents who had diabetes and hypercholesteremia were more likely to recognize all five HA symptoms. For those who had excellent awareness of all five HA symptoms, the odds ratio (OR) were significantly higher among single respondents (OR 0.023; 95% CI 0.001–0.594), Malay (OR 0.376; 95% CI 0.193–0.733), and those who received information associated with HA (OR 7.540; 95% CI 2.037–27.914). However, those who were aware that HA requires quick treatment had significantly low odds ratio (OR 0.176; 95% CI 0.044–0.710). Conclusions: The awareness of and action towards the signs and symptoms of HA among the public were poor.
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Affiliation(s)
- Abdullah Abdulmajid Abdo Ahmed
- Department of Pharmacy Practice, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (A.A.A.A.); (A.M.A.-S.); (S.J.); (A.R.F.N.)
| | - Abdulkareem Mohammed Al-Shami
- Department of Pharmacy Practice, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (A.A.A.A.); (A.M.A.-S.); (S.J.); (A.R.F.N.)
| | - Shazia Jamshed
- Department of Pharmacy Practice, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (A.A.A.A.); (A.M.A.-S.); (S.J.); (A.R.F.N.)
- Qualitative Research-Methodological Application in Health Sciences Research Group, Kulliyyah of Pharmacy, International Islamic University Malaysia, Kuatan 25200, Pahang, Malaysia
| | - Abdul Rahman Fata Nahas
- Department of Pharmacy Practice, International Islamic University Malaysia, Kuantan 25200, Pahang, Malaysia; (A.A.A.A.); (A.M.A.-S.); (S.J.); (A.R.F.N.)
| | - Mohamed Izham Mohamed Ibrahim
- Clinical Pharmacy and Practice Department, College of Pharmacy, QU Health, Qatar University, P.O. Box 2713, Doha, Qatar
- Correspondence: ; Tel.: +974-4403-5580; Fax: +974-4403-5551
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Birnbach B, Höpner J, Mikolajczyk R. Cardiac symptom attribution and knowledge of the symptoms of acute myocardial infarction: a systematic review. BMC Cardiovasc Disord 2020; 20:445. [PMID: 33054718 PMCID: PMC7557019 DOI: 10.1186/s12872-020-01714-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2020] [Accepted: 09/24/2020] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Since the knowledge of the symptoms of acute myocardial infarction (AMI) may reduce the decision time for patients to seek help in case of an AMI, we aimed to summarize evidence on the knowledge of the AMI symptoms and the symptom attribution in case of an acute coronary syndrome (ACS). METHODS Therefore, we systematically searched the databases PubMed, CINAHL, Embase, and Cochrane Library for relevant studies published between January 1, 2008 and 2019 (last search August 1, 2019). RESULTS A total of 86 studies were included, with a composite sample size of 354,497 participants. The weighted mean of the knowledge scores for the symptoms of AMI of 14,420 participants from the general population, was 42.1% (when maximum score was considered 100%) and 69.5% for 7642 cardiac patients. There was a substantially better level of knowledge for six symptoms ('chest pain or discomfort', 'shortness of breath', 'pain or discomfort in arms or shoulders', 'feeling weak, lightheaded, or faint', 'pain or discomfort in the jaw, neck, or back', and 'sweating') (49.8-88.5%) compared to the four less obvious/atypical symptoms 'stomach or abdominal discomfort', 'nausea or vomiting', 'headache', and 'feeling of anxiety' (8.7-36.7%). Only 45.1% of 14,843 patients, who experienced ACS, have correctly attributed their symptoms to a cardiac cause. CONCLUSION In conclusion, we found a moderate to good knowledge of "classic" and insufficient knowledge of less obvious symptoms of AMI. This might suggest that increasing knowledge about less obvious symptoms of AMI could be beneficial. It appears also important to address cardiac attribution of symptoms.
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Affiliation(s)
- Benedikt Birnbach
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Jens Höpner
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany
| | - Rafael Mikolajczyk
- Institute of Medical Epidemiology, Biometrics and Informatics, Interdisciplinary Center for Health Sciences, Martin-Luther University Halle-Wittenberg, Halle (Saale), Germany.
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Rasool SM, Asad Z, Bhatti AA, Kulsoom A, Chaudhary NA, Rasool AS, Sadiq A. Assessment of Knowledge of Symptoms of Ischemic Heart Disease in Population Visiting a Tertiary Care Hospital in Pakistan. Cureus 2019; 11:e5482. [PMID: 31656711 PMCID: PMC6812934 DOI: 10.7759/cureus.5482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
Introduction Cardiovascular diseases are an important cause of mortality in Pakistan. Developing nations like Pakistan with poor literacy rates and the majority of the population living in rural areas seem to be insufficient in their knowledge of symptoms. A study indicated that about half of the cardiac deaths occur within one hour of onset of symptoms, thus it is necessary to have adequate knowledge of symptoms to identify the sufferer and to pursue medical services as early as possible. The aim of our study was to assess the knowledge of ischemic heart disease (IHD) symptoms in the population and to investigate the relationship of age, gender, socio-economic status, education, and occupation with knowledge. Materials and Methods This was a descriptive cross-sectional study carried out in the Holy Family Hospital, Rawalpindi, Pakistan over a period of four months from May 2018 to August 2018. The study population comprised of people visiting the hospital. Individuals aged 18 and above were included while medical professionals were excluded. An interviewer-assisted semi-structured questionnaire was used as the data collection tool. After taking consent, 225 participants were asked about their demographic profile and to enlist as many symptoms of IHD as possible. Reference was made to the seven typical symptoms of IHD as recognized by the World Health Organization (WHO). Statistical Package for Social Sciences (SPSS), v23.0 (IBM SPSS Statistics, Armonk, NY) was used for the analysis. Independent samples t-test and one-way ANOVA test were applied; p ≤ 0.05 was considered significant. Results Out of the seven symptoms endorsed by WHO, chest pain was most frequently identified (42%), followed by pain in the arm (23%), diaphoresis (19%), weakness and fainting (16%), dyspnea (15%), paleness (8%), and sickness and vomiting (5%). Mean score, out of seven symptoms, was 1.28 ± 1.19. Among the total participants, 34% could not enlist any symptom. Participants with higher education, skilled workers, and those having relatives who suffered from IHD showed significantly higher knowledge about IHD symptoms. Conclusions The study showed a paucity of knowledge about IHD symptoms among the participants. Hence it provides grounds for future awareness campaigns to educate the masses.
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Affiliation(s)
| | | | - Awais A Bhatti
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | - Afifa Kulsoom
- Community Medicine, Rawalpindi Medical University, Rawalpindi, PAK
| | | | - Amina S Rasool
- Internal Medicine, Rawalpindi Medical University, Rawalpindi, PAK
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DeVon HA, Vuckovic K, Burke LA, Mirzaei S, Breen K, Robinson N, Zegre-Hemsey J. What's the Risk? Older Women Report Fewer Symptoms for Suspected Acute Coronary Syndrome than Younger Women. Biores Open Access 2018; 7:131-138. [PMID: 30237934 PMCID: PMC6146306 DOI: 10.1089/biores.2018.0020] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
The purpose of the study was to determine whether older (≥65 years) and younger (<65 years) women presenting to the emergency department (ED) with symptoms suggestive of acute coronary syndrome (ACS) varied on risk factors, comorbid conditions, functional status, and symptoms that have implications for emergent cardiac care. Women admitted to five EDs were enrolled. The ACS Symptom Checklist was used to measure symptoms. Comorbid conditions and functional status were measured with the Charlson Comorbidity Index and Duke Activity Status Index. Logistic regression models were used to evaluate symptom differences in older and younger women adjusting for ACS diagnosis, functional status, body mass index (BMI), and comorbid conditions. Analyses were stratified by age, and interaction of symptom by age was tested. Four hundred women were enrolled. Mean age was 61.3 years (range 21–98). Older women (n = 163) were more likely to have hypertension, hypercholesterolemia, never smoked, lower BMI, more comorbid conditions, and lower functional status. Younger women (n = 237) were more likely to be members of minority groups, be college-educated, and have a non-ACS discharge diagnosis. Younger women had higher odds of experiencing chest discomfort, chest pain, chest pressure, shortness of breath, nausea, sweating, and palpitations. Lack of chest symptoms and shortness of breath (key symptoms triggering a decision to seek emergency care) may cause older women to delay seeking treatment, placing them at risk for poorer outcomes. Younger African American women may require more comprehensive risk reduction strategies and symptom management.
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Affiliation(s)
- Holli A DeVon
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Karen Vuckovic
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Larisa A Burke
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Sahereh Mirzaei
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Katherine Breen
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
| | - Nadia Robinson
- Department of Biobehavioral Health Science, College of Nursing, University of Illinois at Chicago, Chicago, Illinois
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Chau PH, Moe G, Lee SY, Woo J, Leung AYM, Chow CM, Kong C, Lo WT, Yuen MH, Zerwic J. Low level of knowledge of heart attack symptoms and inappropriate anticipated treatment-seeking behaviour among older Chinese: a cross-sectional survey. J Epidemiol Community Health 2018; 72:645-652. [PMID: 29581229 DOI: 10.1136/jech-2017-210157] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2017] [Revised: 03/12/2018] [Accepted: 03/13/2018] [Indexed: 11/03/2022]
Abstract
BACKGROUND Prehospital delay of acute myocardial infarction (AMI) is common globally, and Hong Kong-home of a rapidly ageing Chinese population-is not an exception. Seeking emergency medical care promptly is important for patients. Treatment-seeking behaviours have been shown to be associated with knowledge of AMI symptoms and specific cultural beliefs. This study aimed to assess the level of knowledge of AMI symptoms and expected treatment-seeking behaviour among older Chinese in Hong Kong. METHODS A cross-sectional population-based survey was conducted at the Elderly Health Centres in Hong Kong from March to September 2016. Face-to-face interviews were conducted with a structured questionnaire based on previous studies and local adaptations. RESULTS Among 1804 people aged 65 years and above who completed the questionnaire, chest pain (80.2%), palpitations (75.8%) and fainting (71.9%) were the major symptoms recognised as AMI related. Meanwhile, stomach ache (46.9%), coughing (45.4%) and neck pain (40.8%) were recognised as not AMI related. The mean expected discomfort intensity during AMI onset was 7.7 out of 10 (SD=2.1). Regarding the expected treatment-seeking behaviour, seeking non-emergent medical care was the most popular action when AMI symptoms emerged during the day, without chest pain or with lower discomfort intensity, whereas calling an ambulance was the most common option when AMI symptoms emerged at night or with high discomfort intensity. CONCLUSIONS To minimise delays in seeking treatment, future health education should focus on increasing the public knowledge of AMI symptoms and the need to call an ambulance during an emergency.
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Affiliation(s)
- Pui Hing Chau
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Gordon Moe
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Siu Yin Lee
- Department of Health, Elderly Health Service, Hong Kong, China
| | - Jean Woo
- Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong, China
| | - Angela Y M Leung
- Centre for Gerontological Nursing, School of Nursing, The Hong Kong Polytechnic University, Hong Kong, China
| | - Chi-Ming Chow
- Department of Medicine, University of Toronto, Toronto, Canada
| | - Cecilia Kong
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Wing Tung Lo
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Ming Hay Yuen
- School of Nursing, The University of Hong Kong, Hong Kong, China
| | - Julie Zerwic
- College of Nursing, University of Iowa, Iowa City, Iowa, USA
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Yonemoto N, Kada A, Yokoyama H, Nonogi H. Public awareness of the need to call emergency medical services following the onset of acute myocardial infarction and associated factors in Japan. J Int Med Res 2018; 46:1747-1755. [PMID: 29490526 PMCID: PMC5991256 DOI: 10.1177/0300060518757639] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Objectives Early recognition of acute myocardial infarction (AMI) and early activation of emergency medical services (EMS) are essential to reduce delays in patient care. We investigated public awareness of the need to call EMS at onset of AMI and evaluated associated factors. Methods In January 2008, a nationwide population-based survey using quota sampling was conducted in Japan. The primary outcome measure was responsiveness to promptly calling EMS at AMI onset, subdivided by on-time (daytime) and off-time (nights and holidays) hours. Results In total, 1200 participants were surveyed. Their mean age was 46.3 years (standard deviation, 17.4), and 50.3% (n=604) were women. A total of 11.6% (n=139) answered that they would call EMS during on-time hours, and 27.5% (n=330) stated that they would call during off-time hours. Multivariable analysis showed that the participants’ age, female sex, education level, and self-confidence regarding their understanding of AMI were significant associated factors. The associated factors were almost identical during the off-time hours; only sex was no longer significant. Conclusions Public awareness of the need to call EMS at AMI onset in Japan was low. Previous intervention studies that were not effective may not have targeted groups with significant risk factors.
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Affiliation(s)
- Naohiro Yonemoto
- 1 Department of Biostatistics, Kyoto University School of Public Health, Kyoto, Japan
| | - Akiko Kada
- 2 Department of Clinical Trial and Research, National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Rivero F, Bastante T, Cuesta J, Alfonso F. Health Promotion to Reduce Delays in Seeking Medical Attention in Patients With Acute Coronary Syndrome. Response. REVISTA ESPANOLA DE CARDIOLOGIA (ENGLISH ED.) 2016; 69:714. [PMID: 27235286 DOI: 10.1016/j.rec.2016.04.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/29/2016] [Accepted: 03/30/2016] [Indexed: 06/05/2023]
Affiliation(s)
- Fernando Rivero
- Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
| | - Teresa Bastante
- Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
| | - Javier Cuesta
- Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain
| | - Fernando Alfonso
- Servicio de Cardiología, Hospital Universitario de la Princesa, IIS-IP, Universidad Autónoma de Madrid, Madrid, Spain.
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Rivero F, Bastante T, Cuesta J, Alfonso F. Promoción de salud para reducir el retraso en buscar atención médica de los pacientes con síndrome coronario agudo. Respuesta. Rev Esp Cardiol (Engl Ed) 2016. [DOI: 10.1016/j.recesp.2016.03.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Recognizing the Symptoms of Mental Illness following Concussions in the Sports Community: A Need for Improvement. PLoS One 2015; 10:e0141699. [PMID: 26536016 PMCID: PMC4633152 DOI: 10.1371/journal.pone.0141699] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2015] [Accepted: 10/12/2015] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE To evaluate the awareness of concussion-related symptoms amongst members of the sports community in Canada. METHODS A cross-sectional national electronic survey was conducted. Youth athletes, parents, coaches and medical professionals across Canada were recruited through mailing lists from sports-related opt-in marketing databases. Participants were asked to identify, from a list of options, the symptoms of a concussion. The proportion of identified symptoms (categorized as physical, cognitive, mental health-related and overall) as well as participant factors associated with symptom recognition were analyzed. RESULTS The survey elicited 6,937 responses. Most of the respondents (92.1%) completed the English language survey, were male (57.7%), 35-54 years of age (61.7%), with post-secondary education (58.2%), or high reported yearly household income (>$80,000; 53.0%). There were respondents from all provinces and territories with the majority of respondents from Ontario (35.2%) or British Columbia (19.1%). While participants identified most of the physical (mean = 84.2% of symptoms) and cognitive (mean = 91.2% of symptoms), they on average only identified 53.5% of the mental health-related symptoms of concussions. Respondents who were older, with higher education and household income, or resided in the Northwest Territories or Alberta identified significantly more of the mental health-related symptoms listed. INTERPRETATION While Canadian youth athletes, parents, coaches and medical professionals are able to identify most of the physical and cognitive symptoms associated with concussion, identification of mental health-related symptoms of concussion is still lagging.
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Impact of the "ACT NOW. SAVE A LIFE" public awareness campaign on the performance of a European STEMI network. Int J Cardiol 2015; 197:110-2. [PMID: 26142962 DOI: 10.1016/j.ijcard.2015.06.040] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2015] [Accepted: 06/18/2015] [Indexed: 11/20/2022]
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Anbari K, Mostafavi SM, Ghanadi K. Health Promoting Behaviors in Women of Khorramabad City in Western Iran in 2013. WOMEN’S HEALTH BULLETIN 2014. [DOI: 10.17795/whb-22162] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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