20 Dec Variation and Disparities in Awareness of Myocardial Infarction Symptoms
MedicalResearch.com Interview with:
Shiwani Mahajan, MBBS
Yale/YNHH Center for Outcomes Research and Evaluation (CORE)
New Haven, CT 06510
MedicalResearch.com: What is the background for this study?
Response: Although the mortality rates among patients hospitalized for myocardial infarction (MI) have seen a decreasing trend, patients with MI continue to have a delayed presentation to the hospital and a large number of them die before reaching the hospital. One critical aspect of lowering mortality associated with MI is ensuring timely access to lifesaving emergency cardiac care, for which prompt recognition of symptoms of a MI and appropriate rapid emergency response are crucial. As such, in this study, we used nationally representative data to estimate awareness of 5 common symptoms of a MI (including chest pain or discomfort; shortness of breath; pain or discomfort in arms or shoulders; feeling weak or lightheaded; and jaw or neck or back pain), and the appropriate response to a MI (i.e. calling emergency medical services), among adults in the US.
MedicalResearch.com: What are the main findings?
Response: We found that nearly 6% individuals in our study, or an estimated 13.5 million adults nationally, were not aware of a single symptom of a MI, and nearly 1 in 12 individuals, or an estimated 19.1 million adults nationally, did not consider even chest pain or discomfort as a MI symptom. These numbers were substantially higher for individuals who were non-Hispanic Black or Hispanic, were not born in the US, had lower education levels, were uninsured, and belonged to lower income subgroups. Among individuals with all 5 of these characteristics, nearly 1 in 5 were not aware of any symptom of a MI. Additionally, 4.5% individuals, or an estimated 10.4 million adults nationally, chose a different response than immediately calling emergency medical services in response to a MI.
MedicalResearch.com: What should readers take away from your report?
Response: Even today, millions of individuals in the US remain unaware of the most critical symptoms of and the appropriate response to a MI, and therefore, are at a high-risk of adverse outcomes after an MI. Several sociodemographic subgroups are particularly at risk of not being aware, and as such, are most in need of and may benefit the most from targeted public health initiatives.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Given that early intervention in patients with MI is crucial to limit ischemic damage, prompt recognition of MI symptoms and rapid decision to seek care can reduce delays from symptom-onset to hospital presentation and improve survival. As such, there is a need for continued efforts to not only improve awareness of the warning signs of a MI but also the importance of early access to medical care. Moreover, recognizing the subgroups that are at highest-risk of being unaware is germane to the current debate of diminishing treatment delays for individuals suffering from a MI, and can help better design healthcare policies and/or campaigns that are specifically tailored for them.
Mahajan S, Valero-Elizondo J, Khera R, et al. Variation and Disparities in Awareness of Myocardial Infarction Symptoms Among Adults in the United States. JAMA Netw Open. 2019;2(12):e1917885. doi:https://doi.org/10.1001/jamanetworkopen.2019.17885
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