Paramedic PapersHome Cardiac (non-arrest) Self-presenting STEMI patients fare worse
Cardiac (non-arrest)
Self-presenting STEMI patients fare worse
Evaluation of Effective Factors in the Prognosis of Patients with Acute Myocardial Infarction Transferred by Emergency Medical Services and Self-Referred Patients in Tehran
Medical Journal of the Islamic Republic of Iran · 2026-07-20 · Added 16 October 2026
Tehran cohort of STEMI patients found those who self-presented had 2.17 times the in-hospital mortality of EMS-transferred patients, alongside longer door-to-balloon times (60 vs 49 minutes).
- Study type
- Cohort
- Design
- Observational cohort with multivariable logistic regression
- Participants
- Not reported
- Main finding
- Self-referred STEMI patients had higher in-hospital mortality than EMS-transferred patients (9.8% vs 5.2%, p = 0.014), longer door-to-balloon times (60.3 vs 49.3 minutes) and 2.17 times the odds of in-hospital death
- Caveat
- Consecutive cases from just two Tehran hospitals over six months of 2021 — confounding by severity between self-presenters and EMS callers is likely
- Bottom line
- Supports current practice
Why it matters in Australia (Medium relevance). The message — calling an ambulance speeds STEMI treatment — matches Australian STEMI pathways and public campaigns, though the observational Tehran setting means the effect size shouldn't be quoted locally.
Learning goal
Recognise the deterioration risks in chest pain patients who self-present rather than call an ambulance.
More
- Topic: Cardiac (non-arrest)
- Daily scan: 16 October 2026
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