1. Home>
2. Specialties>
3. Cardiology>
4. Summary and Comment

Advertising Reduces Delay in MI Hospitalization

The survival benefit of thrombolysis during acute myocardial infarction falls steadily after the first hour of chest pain. Yet patient delay may account for almost two thirds of the time from symptom onset to treatment. This prospective, population-based observational study examined the impact of a multimedia public education campaign in Geneva, Switzerland aimed at reducing prehospital delay for patients with MI.

An intensive 12-month campaign with the slogan "Heart attack? Every minute counts! Call 144!" was initiated via TV and radio news broadcasts, a 30-second cartoon on chest pain, newspaper ads, citywide posters, and leaflets. A cohort of 1337 patients who presented to the emergency department with chest pain during the campaign was compared with 1140 patients evaluated for similar symptoms during the preceding year. During the campaign, overall mean prehospital delay decreased significantly from nearly eight to just under five hours; it decreased by four hours for patients with acute MI.

The reduction in prehospital delay was significant for men (3.5 hours) but not for women (1 hour) under age 75. While weekly emergency visits for chest pain increased, neither mortality nor the percentage of MI patients who underwent PTCA or thrombolysis changed. The entire advertising program cost approximately $250,000.

Comment: A public education campaign can reduce the prehospital delay for men with ischemic chest pain. Nonetheless, the average delay in seeking medical attention during acute MI remained over four hours. The substantial costs, increased ED visits for noncardiac chest pain, and lack of benefit in either mortality or use of PTCA or thrombolysis call into question this nontargeted approach.

— GW Dec

Published in Journal Watch Cardiology October 1, 1996

Citation(s):

Gaspoz J-M et al. Impact of a public campaign on pre-hospital delay in patients reporting chest pain. Heart 1996 Aug 76 150-155.

• Medline abstract (Free)