Which Heart Attack Treatments Are Best? Depends on Your Age
A surprising finding of this study is that while thrombolytics did not seem to increase a heart attack victim's chances during the initial 30 day period, patients who received the drugs did better in the long run. The patients who got either thrombolytic therapy or angioplasty had a lower death rate after one year than those who didn't.
"These are immediate measures, meaning we want to see an immediate result, says David Newman, MD. "We don't usually look at the long-term outcome of these measures." Newman is an emergency room physician at the University of Pittsburgh Medical Center and was not involved in the study.
The study authors admit that these findings are not clear. They write that it may reflect "the absence of a true benefit of thrombolytic therapy in older patients and a tendency to administer these agents to healthier patients."
Newman agrees. "The people who don't get treated with either thrombolytics or angioplasty may all be sicker to begin with. And the ones who get treated are all healthier. So that's why a better one-year survival rate isn't always as impressive as the 30 day survival rate."
The researchers conclude that more studies are needed to determine the best treatment for older patients with suspected heart attacks, and Newman agrees.
"It's not a conclusive study, but raises more questions about whether its safe to give these [clot busting] drugs to elderly patients, especially those over 75," he says.
But one thing that these conclusions do not change, says David Thieman, MD, is what to do if you think you're having a heart attack. Thieman, who was not involved in the study, is an assistant professor of cardiovascular medicine at Johns Hopkins University School of Medicine.
"Whatever one's conclusion about the recent controversy regarding thrombolytics vs. angioplasty in the elderly, the recommendation for people who think they may be having a heart attack is unchanged -- time is vital," he says. "Heart attack patients should immediately call 911 and go to the hospital by ambulance. Patients should not go to the hospital by car or taxi, much less drive themselves to a distant, high-tech hospital that does angioplasty."
For more information from WebMD, see our Diseases and Conditions page on Heart Disease.