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Title Delaying Hospital Visit Increases Long-Term Mortality in Patients with Myocardial Infarction

Hospital ANAM

Date 2022-01-25

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Delaying Hospital Visit Increases Long-Term Mortality 

in Patients with Myocardial Infarction



A study showed that delaying a visit to the hospital following symptom presentation increases long-term mortality in patients with non-ST-segment elevation myocardial infarction.

Diagnosis of acute myocardial infarction is broken down into ST-segment elevation myocardial infarction (STEMI) and non-ST-segment elevation myocardial infarction (NSTEMI) depending on whether an electrocardiogram shows an ST segment elevation. In STEMI, large blood vessels in the heart are blocked causing serious symptoms, whereas in NSTEMI, only small blood vessels are blocked, which may result in relatively minor symptoms.

A research team led by Professors Tae-Hoon Ahn and Jung-Joon Cha from the Department of Cardiology at Korea University Anam Hospital, Professor Myung-Ho Chung from the Department of Cardiology at Chonnam National University Hospital, and Professor Sung-Ah Bae from the Department of Cardiology at Yongin Severance Hospital tracked 6,500 patients with NSTEMI over the course of three years in the Korea Acute Myocardial Infarction Registry study, referred to as KAMIR-NIH. The study found that the long-term mortality rate surged in patients with NSTEMI if they arrived at the hospital 24 hours or more after symptoms appeared.

This study suggests that there may be a close relationship between the increase in acute myocardial infarction mortality and reluctance to go to the hospital since the outbreak of COVID-19.  

The research team analyzed the difference in prognosis by dividing the patients into two groups: one group that arrived at the hospital within 24 hours following symptom presentation and another group that arrived after 24 hours. The patients in the group that arrived after 24 hours had a 1.62 times higher three-year mortality rate than those who came to the hospital within 24 hours. The risk factors that contributed to a delay in visiting the hospital included old age, being a woman, non-specific chest pain, shortness of breath, having diabetes, and not using an ambulance.

Professor Ahn said, "This study indicates that it is critical to visit the hospital as soon as possible in order to receive an accurate diagnosis and treatment when patients have chest pain or shortness of breath. This is even more important to remember these days due to COVID-19."

Professor Cha explained, "This study confirmed that when patients with acute myocardial infarction delay visiting the hospital, they are increasing their risk of mortality regardless of any underlying diseases. We hope our patients will have a chance to take advantage of our excellent medical system and cardiovascular disease treatment capabilities.” He also stressed, “We need to educate people so that patients with acute myocardial infarction will come to the hospital without any delay. We need ongoing campaigns to educate people about the symptoms of acute myocardial infarction.”

Professor Bae said, "STEMI is often accompanied by severe symptoms, so patients tend to come to the hospital immediately. However, symptoms of NSTEMI can be evasive, especially in those who have underlying diseases, such as diabetes, or in very old patients. That is why it is so important to educate patients and encourage them to come to the hospital without any delay using the emergency medical system." 


The study titled "Clinical Outcomes in Patients with Delayed Hospitalization for Non-ST-Segment Elevation Myocardial Infarction" has been published in the latest issue of the world-renowned Journal of the American College of Cardiology (IF=24.094).