Trajectory of prehospital delay in patients with acute myocardial infarction in the Japanese health care system.

Abstract Objective The purpose of this study was to understand the trajectory of prehospital delay in patients with acute myocardial infarction (AMI) in the Japanese health care system, which offers patients a choice between seeking treatment in a neighborhood clinic/small hospital (clinic group) or a large hospital with comprehensive cardiac services, including a cardiac catheterization laboratory (hospital group). Methods In this cross sectional study, 155 consecutive patients admitted with AMI to one of 5 urban hospitals in Japan were interviewed within 7 days after admission. Results The median total prehospital delay time in the clinic group ( n =84) was significantly longer than the hospital group ( n =71) (6 h and 48 min vs 2 h and 9 min, p Conclusions Findings support the need for public education in Japan that focuses on the appropriate response to AMI symptoms. Moreover, regional AMI networks need to be instituted to provide for early transfer for PCI from clinic/small hospitals to tertiary centers.