Too Many Heart Attack Patients Not Receiving Urgent Emergency Treatment

According to a recently published study, cardiologists from the University of Michigan and the Yale University School of Medicine found that 10 percent of heart attack patients who could benefit from emergency angioplasty treatment or treatment with fibrinolytic (clot busting) drugs are not receiving either. Certainly many more heart attack patients are receiving appropriate treatment in 2007 than were receiving it 10 years ago, but urgent treatment known to save lives and prevent permanent heart muscle damage is still lacking.

In Wednesday's news release, the study is said to have found that those most likely to miss out on critical emergency treatment were people who didn't exhibit typical heart attack symptoms, specifically chest pain; those who didn't reach the hospital until six or more hours after the onset of the heart attack; women; people older than 75; and non-Caucasians.

In fact, the study found, heart attack patients who went to the hospital with heart attack symptoms not including chest pain were less than one-third as likely as those with chest pain to get emergency reperfusion treatment. Those who arrived at the hospital six or more hours after the onset of symptoms were 40 percent less likely to get emergency reperfusion treatment. (Reperfusion refers to the treatments that can break up blood clots and other blockages in the tiny blood vessels of the heart and restore blood flow to the heart muscle.)

Dr. Brahmajee Nallamothu is an assistant professor of cardiovascular medicine at the U-M Medical School and one of the study's authors. Regarding the 10 percent who are not receiving urgent treatment that could save their lives, Dr. Nallamothu said: "We may never be able to get to 100 percent, but 10 percent of eligible patients going untreated is still too many. We hope our study highlights the opportunities to improve care and particularly some of the 'at-risk' subgroups still less likely to receive reperfusion therapy despite eligibility, so that we can focus our clinical efforts on them."

Dr. Harlan Krumholz is a highly accredited professor of medicine and director of the Yale-New Haven Hospital research center. Dr. Krumholz added: "This study has good and bad news. We have definitely made progress in treating appropriate patients, but our findings indicate that we need to improve further to be sure that no patient who could benefit from this treatment is missed."

The news release says that studies have clearly shown that patients who are treated with angioplasty within an hour or two of arrival at the hospital emergency room do better over time than those who wait longer. Therefore, hospitals nationwide are now participating in a national campaign to reduce the time interval for patients who receive emergency angioplasty. The new release says that if angioplasty was used in a timely manner for the 10 percent who are currently not receiving it, up to 30 more lives out of every 1,000 heart attack patients could be saved.

In fact, the study authors believe, this is so significant that hospitals should be judged in part by their ability to deliver acute reperfusion to as many candidate patients as possible. "Our findings support the incorporation of a measure of reperfusion use into national quality improvement efforts," the authors write in their findings. This has been endorsed by a task force created by the American College of Cardiology/American Heart Association, as well.

Source:

News release, Many Heart Attack Patients Don't Get Best Emergency Treatment; http://www.newswise.com/articles/view/532090/