Factors Associated With Delayed Presentation for Myocardial Infarction Among Patients in Iraq

Background Myocardial infarction (MI) is a leading cause of morbidity and mortality worldwide, characterized by myocardial necrosis due to acute coronary artery obstruction. Early hospital presentation optimizes reperfusion therapy and reduces complications, yet delays persist, especially in low- and middle-income countries like Iraq.​ Patients and methods This cross-sectional retrospective study was conducted in Baghdad, Iraq, from April to October 2025 and included 150 adult patients with acute MI presenting to the emergency department. Data from medical records assessed demographics, clinical factors, and presentation timing (delayed if >12 hours’ post-symptom onset). Fisher's exact test identified associations (p<0.05 significant).​ Results Of 150 patients, 59 (39.3%) presented early (≤12 hours) and 91 (60.7%) presented late (>12 hours). Delayed presentation was significantly associated with older age (≥55 years; p=0.014, OR=2.59, 95% CI=1.24-5.40), diabetes mellitus (p=0.025, OR=2.42, 95% CI=1.17-5.01), dyslipidemia (p=0.013, OR=2.49, 95% CI=1.24-5.01), and nighttime symptom onset (12 AM-8 AM; p=0.008, OR=2.50, 95% CI=1.28-4.91). No significant associations emerged for gender (p=0.735), BMI (p=0.464), education (p=0.664), residency (p=0.729), hypertension (p=0.467), family history (p=0.650), or prior percutaneous coronary intervention (p=0.721).​ Conclusion Over 60% of Iraqi MI patients presented later than 12 hours after symptom onset, with delayed presentation linked to older age, diabetes, dyslipidemia, and nighttime onset. Addressing these via targeted education could enhance outcomes.