Delays in admission of patients with acute myocardial infarction to coronary care: implications for thrombolysis

Abstract

Of 408 patients presenting to a coronary care unit over a six month period 237 had an acute myocardial infarction. Two-thirds presented to hospital within three hours of the onset of symptoms. The median delay between arrival in hospital and admission to the Coronary Care Unit was 60 minutes. Only a minority of patients with acute myocardial infarction were eligible to receive thrombolysis, the most common exclusion criteria being an electrocardiograph that was not diagnostic of infarction at presentation. In-hospital transfer delay has increased considerably since 1972. It did not exclude many patients from receiving thrombolysis but it caused delayed thrombolysis.