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The first six hours following acute myocardial infarction (AMI; heart attack) are crucial, particularly since powerful new therapies are available that are most effective during this time. The factors influencing the delay between symptoms and arrival at the hospital have been studied, particularly in recent decades. Studies finding that patients who had previously had AMIs tended not to arrive at the hospital earlier were used to argue that public education campaigns to decrease delay would be ineffective. The factors influencing delay before hospital arrival of 908 of 921 Swedish patients with AMI were evaluated. The average delay time was 3 hours and 10 minutes, and younger patients tended to arrive early. Patients who had electrocardiogram changes indicative of AMI tended to arrive early, and these patients are usually allowed thrombolytic (clot-breaking) therapy, which is one of the new effective AMI treatments. Unlike previous studies, this study found that patients who had previous MIs arrived earlier. Patients with more severe infarcts, who probably had worse symptoms, arrived earlier as well, as did those who arrived by ambulance. The study indicates that factors influencing delay between AMI symptoms and hospital admission have remained the same over the past decades. (Consumer Summary produced by Reliance Medical Information, Inc.)