In conclusion, the strength of this study is that it examined a range of demographic factors in relation the pre-hospital delay and its components simultaneously. Independent predictors of short decision time included recognizing symptoms as cardiac, being away from home and being with a bystander when they started, where as home-to-hospital delay was predicted by younger age, experiencing an STEMI and a greater number of symptoms and being away from home. It seems likely that the pattern of symptoms and their interpretation, and the social context in which symptoms occur impact on appraisal and coping strategies at different points along the timeline from onset to hospital admission. The interplay between patients' belief that they may be having a heart attack and social context seems to be a salient area for future research if we are to understand more about which specific factors predict the individual components of delay so as to target interventions effectively.