The key to a fast and speedy recovery for heart attack patients is accessibility to treatment. Once a heart attack diagnosis is confirmed, patients can limit the damage to the heart muscle by undergoing two main treatments: "clot-busting" medicines and angioplasty, which is a procedure used to open blocked coronary arteries, according to the National Heart, Lung, and Blood Institute. These treatments are specifically designed to restore blood flow to the arteries so patients can return to their normal everyday activities, including work. Patients diagnosed with ST-elevation myocardial infarction (STEMI) are typically found to have a blood clot that suddenly forms in a coronary artery and requires quick treatment. STEMI patients who undergo delays in emergency medical treatment for more than two hours are found to return to work later and seek early retirement, according to a recent study.
In the study, researchers collected data on 4,061 patients under 67 years old who were admitted to the hospital with STEMI to reveal how a system delay could affect a patient’s future work history. A system delay was defined as the time from emergency medical service call to reperfusion with primary angioplasty. According to the National Health Service, a reperfusion is the restoration of blood flow through a clogged artery, while a primary angioplasty is the common procedure used to make this possible.
Kristina Laut, a Ph.D. student at the Faculty of Health at Aarhus University in Denmark, led the investigation and referred to the Danish National Register on public transfer payments for details of work outcomes of these patients. Only STEMI patients who were employed full- or part-time three years before their STEMI admission were included in the study. The researchers used cut-off points of four and eight years to make sure that 10 percent of patients remained for each of the analyses, according to Science Daily.
After four years of follow-up, 91 percent of the participants in the study returned to work. After eight years of follow-up, 29 percent had retired. These findings coincide with the researchers’ hypothesis: a system delay is associated with a postponed return to work. The participants who experienced a delay of 120 minutes, or two hours, had a later work return and were more likely to retire early.
“A large proportion of STEMI patients did return to the labor market within 4 years but 14% came back to work later because of a prolonged system delay. We also discovered that after 8 years, people with a long system delay had a 21% increase in retirement rate,” Laut said, Science Daily reports.
While the researchers found a strong correlation between increased system delay and later work return and early retirement, they expressed the need to have more studies to find out why this is the case. A late return to work could possibly be influenced by a reduction in the ventricular function of the heart, but researchers believe other factors may be involved.
A patient’s gender was not directly influenced by system delay. While there were no notable differences between men and women, the researchers did find that men returned to work later than women. These results could be skewed because there was a very small proportion of women for the study, and these men may have had more physically demanding jobs.
What's more, a strong association between marital status and system delays in heart attack patients was found in the study. Unmarried patients were found to have a shorter system delay but a greater probability for retirement. "Most unmarried people live in big cities and are close to the biggest catheterisation labs which could lead to shorter system delays. Their increased risk of retirement may be because they are more socially vulnerable or don't have the encouragement and support to stay at work,” Laut said, reports Science Codex.
The researchers call for a reevaluation of the health care systems to make sure that these patients get quick access to treatments, and to optimize pre-hospital diagnosis for patients. “[STEMI] patients also need to react quickly to their symptoms and call an ambulance," said Laut.