Despite public campaigns for calling rapidly the emergency phone number in case of chest pain, many patients still delay their call. We sought to determine factors influencing the call delay in case of STEMI.

We studied 206 consecutive patients admitted for STEMI. They were classified according to tertiles of delay between symptoms onset and the first call (« early-callers » for 1st & 2nd tertiles, « late-callers » for the 3rd tertile). We compared these 2 groups according to the registry data. We contacted the survivors to obtain further information on socio-economic status and events during symptoms onset.

The patients (age 64±14 y, 75% males) called on average in 2.5±3.5 hours (early-callers 1.6±1.8 vs. 4.4±5.0 for late-callers). In multivariate analysis, the following factors were significantly associated with late call: age (OR=1.03, 95%CI: 1.00-1.05), living >30 min. from cath lab (OR=2.8, 1.1-7.1), symptoms onset between 00:00-05:59 am (OR=2.3, 1.1-4.8) and first call to the family physician (OR=1.9, 1.8-3.6). The respondents to interview did not differ from others regarding age and call delay. Main variables during interview are compared between in the 2 groups in Figure. In a second model using interview variables, following factors were associated with late call, adjusted for age and sex: symptoms onset between 00:00-05:59 am (OR=3.8, 1.00-14.5), self-medication (OR=7.7, 2.2-27.0), mild pain (visual scale <6: OR=10.0, 2.94-33.3) and symptoms onset out of home (OR=6.7, 1.04-50.0). We found no association between call delay and education level, occupation, cardiovascular risk factors and history.

Delayed call for STEMI is multifactorial. Our data are useful to target the population and highlight messages in future campaigns.