<div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="260882030" paraeid="{b40270a2-8efc-4485-8d05-7297eba80ab3}{245}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Community</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>education about heart attack</span><span class="NormalTextRun SCXW209350507 BCX0">s</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>and acute coronary syndrome (ACS) in high-risk areas does not improve emergency medical service (EMS) use nor early screening for<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW209350507 BCX0">ACS,</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>a randomized trial shows.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{"134233117":false,"134233118":false,"201341983":0,"335551550":1,"335551620":1,"335559685":0,"335559737":0,"335559738":0,"335559739":160,"335559740":279}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1113270673" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{12}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Janet E. Bray, PhD, of Monash University, Victoria, Australia, and colleagues, reported these data on Monday in a manuscript published online in</span><span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">JAMA Network Open</span><span class="NormalTextRun SCXW209350507 BCX0">.</span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="120701108" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{14}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">ACS requires prompt treatment to improve mortality rates and clinical outcomes.<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW209350507 BCX0">Few</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>ACS patients<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">immediately</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>call EMS</span><span class="NormalTextRun SCXW209350507 BCX0">. Most ACS patients delay care, and limited strategies are available to increase EMS use.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1435309823" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{16}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Investigators in the Heart Matters trial examined the<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">impact</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>of community education<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">covering topics</span><span class="NormalTextRun SCXW209350507 BCX0">,</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>such as increased awareness of ACS risk, knowledge about heart disease and treatment-seeking behaviors when one has ACS</span><span class="NormalTextRun SCXW209350507 BCX0">,<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">on ACS outcomes in communities with higher cardiovascular risk and low EMS usage rates</span><span class="NormalTextRun SCXW209350507 BCX0">.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="2100765583" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{18}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">A total of eight high-risk communities were evaluated in this stepped-wedge cluster randomized clinical trial: four metropolitan and four rural<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">local government areas in Victoria, Australia. Data were collected from December 2021 through March 2023, and follow-up was conducted through March 2024. Every four months, clusters crossed to the intervention.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1426962818" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{20}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">For</span><span> </span><span class="NormalTextRun SCXW209350507 BCX0">10,088 residents</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>in the community, the investigators extended 490 community sessions; over 174,000 mailouts; over 50,000 resource brochures;<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">various media educational tools; and a targeted social media campaign. Patients in the control group did not see the educational<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">campaign</span><span class="NormalTextRun SCXW209350507 BCX0">.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1257511419" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{22}"><span class="NormalTextRun SCXW209350507 BCX0">The proportion of patients who had ACS and were transported to hospitals via EMS was the primary outcome in this trial. The Victoria Emergency Minimum Dataset contributed the data for the primary outcome.</span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1262010016" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{24}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">A total of 1,775 patients with ACS (intervention n=865; control n=910; over 50% of patients were 65 years old or older; 67.2% men)</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>were included in the trial. During the control period, rates of EMS increased significantly. The investigators noted that this corresponded with the COVID-19 wave.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" paraid="1068699978" paraeid="{44fc242c-521e-495b-9ede-b66bac3742db}{26}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">During the control patient, 68.6% of patients with ACS<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">utilized</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>EMS<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">transpo</span><span class="NormalTextRun SCXW209350507 BCX0">r</span><span class="NormalTextRun SCXW209350507 BCX0">t</span><span class="NormalTextRun SCXW209350507 BCX0">, and 63.4% of patients used EMS transport during the intervention period (adjusted risk difference [RD]: =8.98</span><span class="NormalTextRun SCXW209350507 BCX0">%, 95% confidence interval [CI]: -17.50% to –0.46%; p=0.04; adjusted odds ratio [OR]=0.67</span><span class="NormalTextRun SCXW209350507 BCX0">, 95% CI=0.45-1.01, p=0.05).</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="334765555" paraeid="{7064ba9c-2a51-45bd-aec4-12b7a2fd0c11}{51}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Metropolitan areas had greater reductions in EMS use, and severe flooding events decreased EMS use. Patients were less likely to<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">seek</span><span> </span><span class="NormalTextRun SCXW209350507 BCX0">early treatment</span><span class="NormalTextRun SCXW209350507 BCX0">, but the investigators noted that the</span><span class="NormalTextRun SCXW209350507 BCX0">se estimates were not precise enough to be conclusive.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="465924270" paraeid="{53574ec7-faf2-4121-a17a-f7012e388461}{212}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">The Heart Matters trial also<span> </span></span><span class="NormalTextRun SCXW209350507 BCX0">observed</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>the impacts of the COVID-19 pandemic and community concerns about the cost of EMS services, EMS<span> </span></span><span class="NormalTextRun ContextualSpellingAndGrammarErrorV2Themed SCXW209350507 BCX0">demand</span><span class="NormalTextRun SCXW209350507 BCX0"><span> </span>and wait times for EMS.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1951820306" paraeid="{8526545c-a965-4af1-9467-70a870909220}{127}"><span class="NormalTextRun SCXW209350507 BCX0">“These results have important implications for policy and practice, particularly as largescale mass media campaigns may not shift long-term awareness19 and behavior. Our intervention, while delivered in high-risk regions, may not have been sufficiently targeted or sustained to overcome long-standing barriers,” the investigators wrote.</span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1660310124" paraeid="{92a4aac5-0bd0-46a1-ab3f-365b7264a7db}{66}"><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Overall, the use of EMS nor early-care seeking was improved with the use of ACS community education in high-risk areas</span><span class="NormalTextRun SCXW209350507 BCX0">, but other intervention effects may have influenced these outcomes. Future research is needed to consider other educational promotions or more targeted strategies.</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1887349126" paraeid="{33b65222-92b8-4a09-9e31-748ee5fe4192}{67}"><strong><span class="NormalTextRun SCXW209350507 BCX0">Source:</span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></strong></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="2036541474" paraeid="{33b65222-92b8-4a09-9e31-748ee5fe4192}{111}"><span class="NormalTextRun SCXW209350507 BCX0">Bray JE, Nehme Z, Finn JC, et al. Heart attack education and EMS response in high-risk, low EMS usage areas: A stepped-wedge cluster-randomized trial.<span> </span></span><em><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">JAMA </span><span class="NormalTextRun SpellingErrorV2Themed SCXW209350507 BCX0">Netw</span><span class="NormalTextRun SCXW209350507 BCX0"> Open</span></span></em><span class="NormalTextRun SCXW209350507 BCX0">. 2026 April 27 (Article in Press).</span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></p> </div> <div class="OutlineElement Ltr SCXW209350507 BCX0"> <p class="Paragraph SCXW209350507 BCX0" xml:lang="EN-US" lang="EN-US" paraid="1594351841" paraeid="{b40270a2-8efc-4485-8d05-7297eba80ab3}{40}"><strong><span data-contrast="auto" xml:lang="EN-US" lang="EN-US" class="TextRun MacChromeBold SCXW209350507 BCX0"><span class="NormalTextRun SCXW209350507 BCX0">Image Credit: </span><span class="NormalTextRun SpellingErrorV2Themed SCXW209350507 BCX0">dragonstock</span><span class="NormalTextRun SCXW209350507 BCX0"> – stock.adobe.com</span></span><span class="EOP SCXW209350507 BCX0" data-ccp-props="{}"> </span></strong></p> </div>