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Speedy Angioplasty Is Critical to Heart Attack Patients' Survival

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If logistical problems make performing angioplasty within two hours impossible, Cannon and colleagues suggest that so-called "clot-busting" drugs, also known as thrombolytics, are a better treatment option. Logistical problems can include inadequate hospital facilities or a hospital arrival late at night, when teams that perform catheterization are unavailable.

"If it's the middle of the night and the [cardiac catheterization] lab team can't be mobilized, drug therapy may be a better option," former American Heart Association (AHA) president Sidney Smith, MD, tells WebMD. "As good as angioplasty may be, this study shows that if there is a delay in excess of two hours, you are not going to see an advantage to this therapy." Smith, a professor of medicine at the University of North Carolina, reviewed this study for WebMD.

The study's findings support revised guidelines issued last year by the American College of Cardiology (ACC) and the AHA, calling for angioplasties to be performed within 90 minutes of hospital arrival, give or take 30 minutes.

Smith, who now chairs the ACC/AHA committee that issued the revised guidelines, says this study will help get out the message that timing is critical for angioplasty.

"These findings fall right in line with the committee's recommendations," he says. "They offer more evidence of the need for physicians and health care systems to monitor door-to-balloon times and work to reduce them."

Vital Information:

  • Angioplasty is a procedure that uses a balloon to widen the narrowed or blocked artery of a heart disease patient.
  • A new study shows that heart attack patients who have angioplasty two and a half hours after reaching the hospital are twice as likely to die as those who receive it within the first hour.
  • Timing is critical for the angioplasty procedure, and if it can't be performed quickly, then an alternative treatment with clot-busting drugs may be appropriate, one expert says.
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