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Time lag to hospitalisation and the associated determinants in patients with acute myocardial infarction: the Takashima AMI Registry, Japan
  1. Tanvir Chowdhury Turin1,2,
  2. Yoshikuni Kita1,
  3. Nahid Rumana1,
  4. Yasuyuki Nakamura3,
  5. Naoyuki Takashima1,
  6. Hideki Sugihara4,
  7. Yutaka Morita5,
  8. Kenji Matsui6,
  9. Akira Okayama7,
  10. Katsuyuki Miura1,
  11. Hirotsugu Ueshima1
  1. 1Department of Health Science, Shiga University of Medical Science, Otsu City, Shiga, Japan
  2. 2Department of Medicine, University of Calgary, Calgary, Alberta, Canada
  3. 3Kyoto Women's University, Kyoto, Japan
  4. 4Takashima General Hospital, Takashima, Japan
  5. 5Makino Hospital, Takashima, Japan
  6. 6The University of Tokyo, Tokyo, Japan
  7. 7The First Institute for Health Promotion and Health Care, Tokyo, Japan
  1. Correspondence to Tanvir Chowdhury Turin, Department of Health Science, Shiga University of Medical Science, Seta Tsukinowa-cho, Otsu City, Shiga 520-2192, Japan; dr.turin{at}


Background Prompt initiation of treatment is the cornerstone in the management of patients with acute myocardial infarction (AMI). The time lags for AMI hospitalisations were examined to identify the factors influencing the interval.

Methods Time lag information was available for 273 men and 148 women from the Takashima AMI Registry during 1988–2006. Multivariate regression analyses were performed to evaluate the factors influencing early and late admission.

Results The median time to hospitalisation was 2 h (mean 6.1, SD 18.7). Within 2 h of onset, 59.8% patients arrived and 20.6% arrived during the 2–6 h interval. A substantial number of patients (19.6%) arrived after 6 h and onwards. A time lag of >2 h in hospital admission was significantly influenced by history of hypertension, angina, presence of syncope as an initial symptom and time of AMI onset. A time lag of >6 h shared similar characteristics except for presence of history of angina.

Conclusions About one-fifth of patients with AMI have prolonged time lag in the study population. Future research intervention and health promotion activities should focus on achieving a reduction in presentation delays.

  • Acute myocardial infarction
  • hospital delay
  • time lag
  • registry
  • Japan
  • cardiac care
  • acute myepidemiology

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  • Funding Funding was in part by grants from The Research on Cardiovascular Disease (3A-1, 6A-5 and 7A-2), The Comprehensive Research on Cardiovascular and Life Style Related Diseases (H18-CVD-Ippan-029) of the Ministry of Health and Welfare, and Grants-in-Aid Scientific Research (B-17390186, B-20390184, C-213670361 and No.17015018) of Ministry of Education, Culture, Sports, Science and Technology. TCT and NR are supported by the fellowships and Research Grants-In-Aid (P-20.08124 and P-21.09139) from the Japan Society for the Promotion of Science.

  • Competing interests None.

  • Ethics approval This study was conducted with the approval of the Institutional Review Board of Shiga University of Medical Science.

  • Provenance and peer review Not commissioned; externally peer reviewed.