ISCTE-Instituto Universitário de Lisboa, Lisboa, Portugal.
Escola Superior de Saúde da Cruz Vermelha Portuguesa, Portuguesa, Portugal.
PLoS One. 2023 Oct 25;18(10):e0284915. doi: 10.1371/journal.pone.0284915. eCollection 2023.
During Stent for Life Initiative in Portugal lifetime, positive changes in ST elevation myocardial infarction treatment were observed, by the increase of Primary Angioplasty numbers and improvements in patients' behaviour towards myocardial infarction, with an increase in those who called 112 and the lower proportion attending non primary percutaneous coronary intervention centres. Despite public awareness campaigns and system educational programmes, patient and system delay did not change significantly over this period. The aim of this study was to address the public awareness campaign effectiveness on peoples' behaviour facing STEMI, and how Covid-19 has affected STEMI treatment.
Data from 1381 STEMI patients were collected during a one-month period each year, from 2011 to 2016, and during one and a half month, matching first lockdown in Portugal 2020. Four groups were constituted: Group A (2011); Group B (2012&2013); Group C (2015&2016) and group D (2020).
The proportion of patients who called 112, increased significantly (35.2% Group A; 38.7% Group B; 44.0% Group C and 49.6% Group D, p = 0.005); significant reduction was observed in the proportion of patients who attended healthcare centres without PPCI (54.5% group A; 47.6% Group B; 43.2% Group C and 40.9% Group D, p = 0.016), but there were no differences on groups comparison. Total ischemic time, measured from symptoms onset to reperfusion increased progressively from group A [250.0 (178.0-430.0)] to D [296.0 (201.0-457.5.8)] p = 0.012, with statistically significant difference between group C and D (p = 0.034).
During the term of SFL initiative in Portugal, patients resorted less to primary health centres and called more to 112. These results can be attributed the public awareness campaign. Nevertheless, patient and system delays did not significantly change over this period, mainly in late years of SFL, probably for low efficacy of campaigns and in 2020 due to Covid-19 pandemic.
在葡萄牙的“Stent for Life 倡议”期间，观察到 ST 段抬高型心肌梗死治疗发生了积极变化，表现为经皮冠状动脉介入治疗（PCI）数量增加以及患者对心肌梗死的行为改善，拨打 112 的患者比例增加，而非 PCI 中心就诊的比例降低。尽管开展了公众意识宣传活动和系统教育项目，但在此期间，患者和系统延迟并没有显著变化。本研究旨在探讨公众意识宣传活动对 ST 段抬高型心肌梗死患者行为的影响，以及新冠疫情如何影响 ST 段抬高型心肌梗死的治疗。
在 2011 年至 2016 年期间，每年在一个月内收集 1381 例 ST 段抬高型心肌梗死患者的数据，在 2020 年葡萄牙第一次封锁期间收集了一个半月的数据。将患者分为四组：A 组（2011 年）、B 组（2012 年和 2013 年）、C 组（2015 年和 2016 年）和 D 组（2020 年）。
拨打 112 的患者比例显著增加（A 组 35.2%；B 组 38.7%；C 组 44.0%；D 组 49.6%，p = 0.005）；到非 PCI 中心就诊的患者比例显著下降（A 组 54.5%；B 组 47.6%；C 组 43.2%；D 组 40.9%，p = 0.016），但组间比较无差异。从症状发作到再灌注的总缺血时间从 A 组[250.0（178.0-430.0）]逐渐增加到 D 组[296.0（201.0-457.5），p = 0.012]，C 组和 D 组之间存在统计学差异（p = 0.034）。
在葡萄牙“Stent for Life 倡议”期间，患者较少前往初级保健中心，更多地拨打 112。这些结果归因于公众意识宣传活动。然而，在此期间，患者和系统延迟没有显著变化，主要是在“Stent for Life 倡议”后期，可能是由于宣传活动效果不佳，以及 2020 年新冠疫情的影响。
