Background: Acute coronary syndrome (ACS) is currently the leading cause of morbidity and mortality worldwide. The prognosis of ACS treatment outcome depends on the speed of reperfusion after a heart attack; wherein, one of the associated factors is pre-hospital time.

Method: A retrospective study was conducted in ACS patients, who visited the emergency room of a tertiary hospital; from 1st January to 31st December 2020. The primary outcome was pre-hospital time; and secondary outcome was factors associated with delayed pre-hospital time (≥ 2 hours) that were analyzed by using logistic regression.

Results: The Median age of patients was 64 years (Q1, Q3 = 56, 73), with 75.8% being male. The median pre-hospital time was 2.5 hours (Q1, Q3 = 1.0, 6.0), 63.4% of acute coronary events were delayed pre-hospital time, and 90.1% of events were transported to the hospital by private car. The factors significantly associated with delayed pre-hospital time consisted of adult patients [OR (95%CI) = 2.20 (1.05 - 4.61)], events occurring on weekdays [OR (95%CI) = 2.08 (1.04 - 4.14)] and inside their home [OR (95%CI) = 5.01 (1.67 - 15.06)], final diagnosis with NSTEMI [OR (95%CI) = 2.74 (1.24 - 6.05)], and taking isosorbide in previously diagnosed MI patients [OR (95%CI) = 4.32 (1.42 - 13.17)].

Conclusion: Patients with ACS still delayed seeking treatment, and underutilized emergency medical service systems. Interventions to increase awareness and knowledge of ACS is required to improve the treatment outcomes of ACS patients.

Keywords: acute coronary syndrome, myocardial infarction, pre-hospital time