Ischaemic heart disease

Language barriers driving MI delay

People who do not speak English as their first language are delaying seeking medical help at the first sign of an MI, new research from Melbourne reveals.

Writing in a brief report in the Internal Medicine Journal the research team led by clinician scientist Dr Dion Stub from The Alfred Hospital said the results of their study highlighted that education around cardiovascular symptoms needed to be targeted at non-English speaking populations.

Their study involved 650 patients who underwent primary PCI for STEMI at a multi-centre tertiary health service in Melbourne, 98 of whom self reported as having limited english proficiency (LEP).

Door-to-balloon times were similar in LEP patients  and those who were proficient in English (EP) at 71 minutes vs 68 minutes.

However, total ischaemic time – defined as time from symptom onset to first balloon inflation in a coronary artery – was significantly longer in patients with limited english (281 minutes vs 203 minutes). The authors said this finding was driven by longer symptom to door times (193 minutes vs 120 minutes).

LEP was found to be an independent risk factor for prolonged symptom to door time (OR 1.63).

The median length of hospital stay was equal between both groups and there were no differences in in-hospital mortality and major adverse cardiac events between the two groups.

“Whilst it is reassuring that STEMI systems of care are robust such that LEP patients are not disadvantaged within the health system, these results highlight the need for better education about cardiovascular emergencies targeted to non-English speaking communities,” the study authors concluded.

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