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Pain symptoms and delays healthcare decision-making in acute myocardial infarction

Heart Science Journal · Vol. 7 No. 1 (2026) · hlm. 92–97

DOI
10.21776/ub.hsj.2026.007.01.16
ISSN
2721-9984, 2721-9976
Terbit
2026-01-31
Penerbit
Universitas Brawijaya
Bahasa
en
Lisensi
creativecommons.org/licenses/by/4.0

Abstrak

Background: Rapid initiation of reperfusion therapy in acute myocardial infarction (AMI) is vital for a favourable prognosis and is significantly affected by the duration from symptom onset to hospital arrival. Previous studies have indicated that cardiac autonomic neuropathy (CAN), prevalent in diabetic patients, may impair pain perception, potentially delaying healthcare-seeking behaviour Objective: This study aimed to compare chest pain characteristics and healthcare-seeking delays between patients with diabetes mellitus (DM) and without DM (non-DM) myocardial infarction. Methods: A cross-sectional study was conducted involving 93 subjects (35 DM and 58 non-DM) diagnosed with either ST-elevation myocardial infarction (STEMI, n=78) or non-ST elevation myocardial infarction (NSTEMI, n=15). Data on symptoms, including pain quality and healthcare-seeking timing within 72 hours of admission, were gathered via a standardized questionnaire. Result: Logistic regression analysis highlighted stabbing pain as a strong predictor (OR = 3.296, p-Value = 0.038), indicating that patients with this symptom are more than three times more likely to delay seeking care. Patients with DM are more frequently reported back-radiating stabbing pain (p<0.05). No significant differences between the groups were observed in pain symptomatology and decision-making delay, although DM patients were more likely to delay seeking care for over two hours. Conclusion: While pain characteristics showed no significant differences between DM and non-DM myocardial infarction patients, DM patients were prone to later healthcare engagement. This delay could be attributed to the misinterpretation of cardiac symptoms as diabetic complications, underscoring the need for targeted patient education. Therefore, strengthened patient education and routine screening for cardiovascular symptoms in individuals with diabetes are essential to support early detection and timely management.

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  • University of Brawijaya
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Rekan penulisOrganisasiArtikel bersama
Cholid Tri TjahjonoUniversity of Brawijaya26
Indra PrasetyaUniversity of Brawijaya25
Setyasih AnjarwaniUniversity of Brawijaya25
Anna Fuji RahimahUniversity of Brawijaya23
Ardian RizalUniversity of Brawijaya21
Novi KurnianingsihUniversity of Brawijaya19
Djanggan SargowoUniversity of Brawijaya16
Sasmojo WiditoUniversity of Brawijaya16
Yoga WaranugrahaUniversity of Brawijaya11
Heny MartiniUniversity of Brawijaya11
Muhammad Rizki FadlanUniversity of Brawijaya6
Putri Annisa KamilaUniversity of Brawijaya5
Adhika Prastya WikanandaUniversity of Brawijaya4
Tri AstiawatiUniversity of Brawijaya4
Dadang HendrawanUniversity of Brawijaya4
Hayla Iqda MillisaniUniversity of Brawijaya4
Fandy HazzyUniversity of Brawijaya3
Wella KarolinaUniversity of Brawijaya3
Oktivani Adelathifa RahmaUniversity of Brawijaya3
Olivia HandayaniUniversity of Brawijaya3
Dea Arie KurniawanUniversity of Brawijaya3
Ayu Asri Devi AdityawatiUniversity of Brawijaya3
Seprian WidasmaraUniversity of Brawijaya3
Valerinna YogibuanaAfiliasi tidak diketahui3
Valerinna Yogibuana Swastika PutriUniversity of Brawijaya3
Shalahuddin Suryo BaskoroUniversity of Brawijaya3
Nikhen NoverikeUniversity of Brawijaya3
Zhafran VeliawanUniversity of Brawijaya3
Veny KurniawatiUniversity of Brawijaya2
Tonny AdriyantoUniversity of Brawijaya2
Jonny Karunia FajarUniversity of Brawijaya2
Fahmy RusnantaUniversity of Brawijaya2
Fitranti Suciati LaitupaUniversity of Brawijaya2
Oktafin Srywati PamunaUniversity of Brawijaya2

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Sumber metadata: OAI-PMH (metadata jurnal) https://heartscience.ub.ac.id/index.php/heartscience/oai, pertama di-harvest 8 Nov 2026, terakhir terlihat 8 Nov 2026.
Metadata asli (oai_dc) 
<oai_dc:dc xmlns="http://www.openarchives.org/OAI/2.0/" xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/  http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
	<dc:title xml:lang="en">Pain symptoms and delays healthcare decision-making in acute myocardial infarction</dc:title>
	<dc:creator xml:lang="en">Ainan, Shafa</dc:creator>
	<dc:creator xml:lang="en">Lukitasari, Mifetika</dc:creator>
	<dc:creator xml:lang="en">Sari, Efris Kartika</dc:creator>
	<dc:creator xml:lang="en">Ahsan, Ahsan</dc:creator>
	<dc:creator xml:lang="en">Rohman, Mohammad Saifur</dc:creator>
	<dc:creator xml:lang="en">Satrijo, Budi</dc:creator>
	<dc:subject xml:lang="en">Acute Myocardial Infarction</dc:subject>
	<dc:subject xml:lang="en">Chest Pain</dc:subject>
	<dc:subject xml:lang="en">Diabetes Mellitus</dc:subject>
	<dc:subject xml:lang="en">Pre-Hospital Delay</dc:subject>
	<dc:subject xml:lang="en">Symptoms</dc:subject>
	<dc:description xml:lang="en">Background: Rapid initiation of reperfusion therapy in acute myocardial infarction (AMI) is vital for a favourable prognosis and is significantly affected by the duration from symptom onset to hospital arrival. Previous studies have indicated that cardiac autonomic neuropathy (CAN), prevalent in diabetic patients, may impair pain perception, potentially delaying healthcare-seeking behaviour
Objective: This study aimed to compare chest pain characteristics and healthcare-seeking delays between patients with diabetes mellitus (DM) and without DM (non-DM) myocardial infarction.
Methods: A cross-sectional study was conducted involving 93 subjects (35 DM and 58 non-DM) diagnosed with either ST-elevation myocardial infarction (STEMI, n=78) or non-ST elevation myocardial infarction (NSTEMI, n=15). Data on symptoms, including pain quality and healthcare-seeking timing within 72 hours of admission, were gathered via a standardized questionnaire.
Result: Logistic regression analysis highlighted stabbing pain as a strong predictor (OR = 3.296, p-Value = 0.038), indicating that patients with this symptom are more than three times more likely to delay seeking care. Patients with DM are more frequently reported back-radiating stabbing pain (p&amp;lt;0.05). No significant differences between the groups were observed in pain symptomatology and decision-making delay, although DM patients were more likely to delay seeking care for over two hours.
Conclusion: While pain characteristics showed no significant differences between DM and non-DM myocardial infarction patients, DM patients were prone to later healthcare engagement. This delay could be attributed to the misinterpretation of cardiac symptoms as diabetic complications, underscoring the need for targeted patient education. Therefore, strengthened patient education and routine screening for cardiovascular symptoms in individuals with diabetes are essential to support early detection and timely management.</dc:description>
	<dc:publisher xml:lang="en">Universitas Brawijaya</dc:publisher>
	<dc:date>2026-01-31</dc:date>
	<dc:type>info:eu-repo/semantics/article</dc:type>
	<dc:type>info:eu-repo/semantics/publishedVersion</dc:type>
	<dc:format>application/pdf</dc:format>
	<dc:identifier>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20310</dc:identifier>
	<dc:identifier>10.21776/ub.hsj.2026.007.01.16</dc:identifier>
	<dc:source xml:lang="en">Heart Science Journal; Vol. 7 No. 1 (2026): Accelerating Clinical Breakthroughs: The Journey from Molecular Discovery to Patient Care; 92-97</dc:source>
	<dc:source>2721-9984</dc:source>
	<dc:source>2721-9976</dc:source>
	<dc:source>10.21776/ub.hsj.2026.007.01</dc:source>
	<dc:language>en</dc:language>
	<dc:relation>https://heartscience.ub.ac.id/index.php/heartscience/article/view/20310/564</dc:relation>
	<dc:rights xml:lang="en">Copyright (c) 2026 Shafa Ainan, Mifetika Lukitasari, Efris Kartika Sari, Ahsan Ahsan, Mohammad Saifur Rohman, Budi Satrijo</dc:rights>
	<dc:rights xml:lang="en">http://creativecommons.org/licenses/by/4.0</dc:rights>
</oai_dc:dc>