Analytical Examination of the Impact of Pre-Hospital Delay on Survival in Acute Myocardial Infarction at University of Abuja Teaching Hospital

Pre-hospital delay in the management of acute myocardial infarction is a major determinant of myocardial salvage and survival, and the duration and determinants of this delay in the Nigerian context have been inadequately characterised. This study analytically examines the duration of pre-hospital delay, its determinants, and its impact on survival in acute myocardial infarction patients at the University of Abuja Teaching Hospital, North Central Nigeria. A prospective cohort design is applied over an 18-month study period, enrolling 180 consecutive patients admitted with ST-elevation or non-ST-elevation myocardial infarction. Total ischaemic time, symptom-onset-to-door time, and door-to-balloon or door-to-thrombolysis time are calculated. Structured patient and family interviews document symptom recognition, first response action, mode of transport, and financial barriers. Clinical outcomes include reperfusion success, left ventricular ejection fraction at discharge, and 30-day mortality. Multiple logistic regression in SPSS identifies determinants of prolonged pre-hospital delay and predictors of 30-day mortality. Available cardiology literature from North Central Nigeria identifies patient-level delay in symptom recognition and decision-making as the longest component of total ischaemic time, with median symptom-to-door intervals exceeding 12 hours in most Nigerian series. The ACC/AHA STEMI Guidelines and GRACE risk score provide the management and prognosis reference. Findings will support the institution's cardiology unit in developing a community cardiac awareness programme. Keywords: acute myocardial infarction, pre-hospital delay, ischaemic time, survival, Abuja.