ABC | Volume 111, Nº4, Octuber 2018

Original Article Rodrigues et al Predictors of late presentation in ST-elevation myocardial infarction Arq Bras Cardiol. 2018; 111(4):587-593 Figure 2 shows the rates of cardiovascular events in 30 days in patients with late presentation or without. Patients with late presentation had significantly higher mortality rates (p < 0.05), and comparisons between groups, considering the occurrence of other clinical outcomes, did not show statistically significant differences. Discussion This study showed that the main predictors of hospital arrival delay in patients with STEMI, treated at a referral hospital in Cardiology in the Southern Region of Brazil, were Black ethnicity, low income and DM, whereas the presence of prior heart disease was associated with earlier arrival. Individuals with all predictors of late presentation had mean time of hospital arrival more than two-fold higher than those who had none of these characteristics. These findings are important, since the time from symptom onset to hospital arrival is one of the main determinants of mortality in STEMI, 3 as also demonstrated in our study. Black ethnicity was one of the independent predictors of late presentation in patients with STEMI in the present study. Figure 1 – Median time of presentation, according to different combinations of late presentation predictors. C: caucasian; B: black; LI: low income (< 5 minimum wages); HI:high income (= 5 minimum wages); DM: diabetes mellitus; NDM: does not have diabetes mellitus; PHD: previous heart disease; NPC: does not have previous heart disease. 20 Delta T 15 10 5 0 B+LI+DM+NPHD C+HI+NDM+PHD C+HI+NDM+NPHD C+LI+DM+NPHD C+LI+NDM+NPHD B+LI+DM+PHD * * * ** * * * * * * Figure 2 – Clinical outcomes in 30 days. STEMI: acute ST-segment elevation myocardial infarction; MCVE: major cardiovascular events. 14 12 10 8 6 4 2 0 6.7 10.2 1.2 0.7 3.6 4.1 11.1 13.3 < 6h ≥ 6h Overall death stroke STEMI MCVE (%) 590