A Descriptive Study on Characteristics of Patients with Myocardial Infarction and Their Outcomes: A Rural Primary Healthcare Setting in Lubok Antu District, Sarawak

Abstract

INTRODUCTION: Myocardial infarction (MI) is the leading cause of death worldwide. More studies are needed to provide insight of MI care in rural settings in Malaysia.
OBJECTIVE: This study aims to define characteristics of patients who experienced MI in rural setting and their outcomes.
METHODS: We conducted an observational study involving secondary data collection through review of medical records of patients who presented to rural primary healthcare facilities before being referred to regional secondary and/or tertiary centres. We explored their outcomes including inpatient and 30-day cardiac-related mortality.
RESULTS: Nine patients were included. Eight (88.9%) experienced STEMI. Eight (88.9%) were male. Median age was 53 (Q1:40.5–Q3:64.5) years. Median duration from symptoms onset to presentation was 2 (1.125 – 35.250) hours. Median time from presentation to aspirin delivery was 45 (12.5 – 86.0) minutes. The median door-to-needle time was 190 (163.0 – 212.5) minutes. Five (55.6%) received medical thrombolysis in secondary hospital prior to elective percutaneous coronary intervention (PCI).  Inpatient mortality was 11.1% corresponding to 30-day mortality.
CONCLUSIONS: MI is potentially under-diagnosed and under-treated in resource-limited rural settings where community awareness is low complicated by logistic challenges. Better resources with better equipped healthcare facilities are essential for prompt diagnosis and interventions for MI patients.