ArticleInternational journal of cardiology. Heart & vasculature2021
Acute coronary syndrome treatment delay in low to middle-income countries: A systematic review.
Article in International journal of cardiology. Heart & vasculature, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 3 of them syntheses that pooled it.
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Who cites it
32 citing papers in PubMed, 3 syntheses or guidelines pooled it.
- Barriers to the Implementation of Acute Coronary Syndrome Guidelines in Healthcare: A Systematic Review.Reviews in cardiovascular medicine · 2026Pooled it
- Acute myocardial infarction treatment delay in South Asia: a systematic review and meta-analysis.Future cardiology · 2025Pooled it
- Effectiveness of acute myocardial infarction interventions on selected outcomes among community dwelling-older adults: a systematic review and meta-analysis.Scientific reports · 2023Pooled it
- Shock Timing in STEMI-CS: Management and Outcomes in a Resource-Limited Setting.JACC. Advances · 2026Article
- Seven-day mortality and its predictors among patients with acute coronary syndrome in southwestern Ethiopia: a prospective cohort study.Global cardiology science & practice · 2026Article
- Pre-Hospital Delay in STEMI: A Narrative Review of Symptom Onset-to-First Medical Contact Across High-Income and Low- and Middle-Income Countries.Clinical cardiology · 2026Review
- Factors Associated With Delayed Presentation for Myocardial Infarction Among Patients in Iraq.Cureus · 2026Article
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- Public awareness of early symptoms of acute coronary syndrome and its association with anticipated prehospital delay: a cross-sectional study in Palestine.Frontiers in public health · 2026Article
- Economic drivers and systemic disparities in invasive coronary angiography: Insights from a national claims database.PloS one · 2026Article
- Barriers to Timely Percutaneous Coronary Intervention (PCI) in Rural vs. Urban Settings: A Health System Approach.Cureus · 2025Article
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- Assessment of the complaints and the hospital application of patients with acute coronary syndrome, and the patient's knowledge and behaviors regarding the management of cardiovascular risk factors.African health sciences · 2025Article
- Characterizing chest pain in patients with acute coronary syndrome at Vietnam National Heart Institute: a case-control study.The Journal of international medical research · 2024Article
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- Smoking and Hypertriglyceridemia Predict ST-Segment Elevation Myocardial Infarction in Kosovo Patients with Acute Myocardial Infarction.Clinics and practice · 2024Article
- Number of comorbidities and the risk of delay in seeking treatment for coronary heart disease: a longitudinal study in Bogor City, Indonesia.Osong public health and research perspectives · 2024Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Although morbidity and mortality rates are declining for acute coronary syndrome (ACS) in most high-income countries, it is rising at an alarming pace for low to middle income countries (LMICs). A major factor that is contributing to the poor clinical outcomes among LMICs is largely due to prehospital treatment delays. This systematic review was conducted to determine the mean length of time from symptom onset to treatment in LMICs and the sociodemographic, clinical and health system characteristics that contribute to treatment delays. We conducted a comprehensive review of the relevant literature published in English between January 1990 through May 2020 using predefined inclusion and exclusion criteria. Twenty-nine studies were included and time to treatment was defined from ACS symptom onset to first medical contact and dichotomized further as less than or >12-hours. The mean time from symptom onset to first medical contact was 12.7 h which ranged from 10-minutes to 96 h. There was consensus among studies that being older, female, illiterate, living in a rural area, and financially limited was associated with longer treatment delays. Lack of a developed emergency transportation system, poor communication and organization between community facilities and interventional facilities were also cited as major contributors for ACS treatment delays. Findings from this systematic review provide future directions to potentially reduce prehospital delays in LMICs and improve ACS outcomes.
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