Wiener klinische Wochenschrift

, Volume 127, Issue 5–6, pp 218–221 | Cite as

Improvement in prehospital time in acute coronary syndrome between 1985 and 2013 in the south-eastern area of Hungary

  • Laszlo Mark
  • Gyӧzӧ Dani
  • Robert Vendrey
  • Janos Ruzsa
  • Andras Katona
short report


Acute coronary syndrome (ACS) is a life-threatening condition and the time-period from the onset of symptoms to the patients’ arrival into the hospital has crucial importance. The authors investigated retrospectively the patients’ decision time (time from the onset of the symptoms to seeking medical help) and the transport time to hospital arrival. In Hungary, it is unique of its kind that the present data can be compared to those obtained in the same area almost three decades ago.

One-hundred forty-two patients (106 males and 36 females) were involved in the study, the mean age ± SD was 62.4 ± 11.3 years. The median decision time was 40 min; the median hospital arrival time was 2 h and 13 min. These were significantly shorter than in 1985–1986. These time parameters were influenced neither by gender, age, the number of inhabitants in the patients’ city, the patients’ education level, the occurrence of any former coronary event in the family and nor by the fact that the type of ACS was myocardial infarction with or without ST segment elevation.

During the last two and half decades both the decision and the hospital arrival time decreased significantly (by 39 and 28 %, respectively) probably due to greater knowledge of general practitioners and the better organized ambulance service. Further improvement is needed; this can be expected by consistent education of the patients.


Acute coronary syndrome Percutaneous coronary intervention Prevention Prehospital time 


  1. 1.
    Hamm CW, Bassand JP, Agewall S, ESC Committee for Practice Guidelines, et al. ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation: The Task Force for the management of acute coronary syndromes (ACS) in patients presenting without persistent ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 2011;32:2999–3054.CrossRefPubMedGoogle Scholar
  2. 2.
    Steg PG, James SK, Atar D, et al. Task Force on the management of ST-segment elevation acute myocardial infarction of the European Society of Cardiology (ESC). ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation. Eur Heart J. 2012;33:2569–619.CrossRefPubMedGoogle Scholar
  3. 3.
    Perk J, De Backer G, Gohlke H, et al. European Guidelines on cardiovascular disease prevention in clinical practice (version 2012): the Fifth Joint Task Force of the European Society of Cardiology and Other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of nine societies and by invited experts). Eur J Prev Cardiol. 2012;19:585–667.CrossRefGoogle Scholar
  4. 4.
    Naegeli B, Radovanovic D, Rickli H, et al. Impact of a nationwide public campaign on delays and outcome in Swiss patients with acute coronary syndrome. Eur J Cardiovasc Prev Rehabil. 2011;18:297–304.CrossRefPubMedGoogle Scholar
  5. 5.
    Kiss Z, Nagy L, Reiber I, et al. Persistence with statin therapy in Hungary. Arch Med Sci. 2012;9:409–17.Google Scholar
  6. 6.
    Márk L, Deli L. Az acut myocardialis infarctus prehospitalis szakának vizsgálata kórházunk ellátási területén. [Examination of the prehospital period of acute myocardial infarction in the area of our hospital]. Népegészségügy. 1987;68:286–8. [Article in Hungarian].Google Scholar
  7. 7.
    Józan P. Rendszerváltozás és epidemiológiai korszakváltás Magyarországon. [Change of the political system and epidemiologic transition in Hungary]. Orv Hetil. 2012;153:662–77. [Article in Hungarian].CrossRefPubMedGoogle Scholar
  8. 8.
    Matejka Zs, Kiss N. A lakossági szűrések hatékonyságának és az ajánlható célcsoportok meghatározásának EBM alapú irodalmi összefoglalója. [The EBM summary for the recommendation and determination of target groups of population screenings] Egészségügyi Szakértő Műhely Kft. Egészségügyi Stratégiai Kutatóintézet. Budapest. 2006. [Article in Hungarian]
  9. 9.
    Ting HH, Bradley EH, Wang Y, et al. Factors associated with longer time from symptom onset to hospital presentation for patients with ST-elevation myocardial infarction. Arch Intern Med. 2008;168:959–68.CrossRefPubMedGoogle Scholar
  10. 10.
    Ting HH, Chen AY, Roe MT, et al. Delay from symptom onset to hospital presentation for patients with non-ST-segment elevation myocardial infarction. Arch Intern Med. 2010;170:1834–41.CrossRefPubMedGoogle Scholar
  11. 11.
    Dracup K, McKinley S, Riegel B, et al. A randomized clinical trial to reduce patient prehospital delay to treatment in acute coronary syndrome. Circ Cardiovasc Qual Outcomes. 2009;2:524–32.CrossRefPubMedCentralPubMedGoogle Scholar
  12. 12.
    Mooney M, McKee G, Fealy G, et al. A randomized controlled trial to reduce prehospital delay time in patients with acute coronary syndrome (ACS). J Emerg Med. 2014;46:495–506.CrossRefPubMedGoogle Scholar
  13. 13.
    Doyle F, De La Harpe D, McGee H, Shelley E, Conroy R. Nine-year comparison of presentation and management of acute coronary syndromes in Ireland: a national cross-sectional survey. BMC Cardiovasc Disord. 2005;5:5.CrossRefPubMedCentralPubMedGoogle Scholar
  14. 14.
    Jánosi A, Ofner P, Merkely B, et al. Szívinfarktus miatt kezelt betegek korai és késői prognózisa. Magyar Infarctus Regiszter Vizsgálat. [Short and long term prognosis of patients with myocardial infarction. Hungarian Myocardial Infarction Registry]. Orv Hetil. 2013;154:1297–302. [Article in Hungarian].CrossRefPubMedGoogle Scholar
  15. 15.
    Jánosi A, Ofner P, Forster T, et al. Clinical characteristics, hospital care, and prognosis of patients with ST elevation myocardial infarction: Hungarian Myocardial Infarction Registry. Eur Heart J Suppl. 2014;16(Suppl A):A12–5.Google Scholar
  16. 16.
    McKee G, Mooney M, O’Donnell S. et al. Multivariate analysis of predictors of pre-hospital delay in acute coronary syndrome. Intern J Cardiol. 2013;168:2706–13.CrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2015

Authors and Affiliations

  • Laszlo Mark
    • 1
  • Gyӧzӧ Dani
    • 1
  • Robert Vendrey
    • 1
  • Janos Ruzsa
    • 1
  • Andras Katona
    • 1
  1. 1.2nd Department of Internal Medicine–CardiologyPandy Kalman Bekes County HospitalGyulaHungary

Personalised recommendations