Coronary disease & ACSCross-sectional study
Presence and type of bystanders on delay time in acute myocardial infarction: a transcultural cross-sectional clinical study with 907 patients in Shanghai and Munich
- cross-sectional observational study
- multicentre MEDEA FAR-EAST study in Shanghai
Authors' conclusion
Non-family bystanders were associated with markedly shorter prehospital delay but their effectiveness differed by sex and cultural context. These findings support a paradigm shift in public health strategies: alongside patient education, community-wide first-aid training and targeted interventions that enable non-family bystanders to act promptly are critical to improving outcomes.
Study context
- Population
- Patients with confirmed acute myocardial infarction (AMI) in Munich and Shanghaipatients with confirmed AMI · MEDEA (Munich) 614 · MEDEA FAR-EAST (Shanghai) 293
- Participants
- 907 patients
- Exposure
- prehospital delay time, analysed by bystander presence and type
- with bystandersn = 636
- Outcome
- Prehospital delay time
Main finding
As reported in the abstract
P = 0.023
Observational data: associations, not effects.
Further findings
| Outcome | Values | P value |
|---|---|---|
| Prehospital delay in women | Women suffering from AMI all alone 254 (IQR 130–725) min · Women living alone but supported by a bystander 166 (IQR 67–979) min | |
| Prehospital delay by city · shorter delays in Shanghai | Shanghai 150 min · Munich 203 min | P < 0.001 |
Prehospital delay with non-family bystanders
- Non-family bystanders consistently facilitated the most rapid responses
- 128 min
Participant characteristics
- women
- 216 (24%)
- median age
- 62 (IQR 54-72) years
- patients who experienced AMI with bystanders
- 636 (70%)
Original publication
Presence and type of bystanders on delay time in acute myocardial infarction: a transcultural cross-sectional clinical study with 907 patients in Shanghai and Munich. Heart. Published 18 June 2026. doi:10.1136/heartjnl-2025-327595
Summarised from the published abstract; every number is checked against it