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Heart Attack Treatment May Lag in Off-Hours

Study Shows Some Treatments Given Faster During Daytime, Weekdays
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WebMD Health News

Aug. 16, 2005 -- A new study shows that heart attack patients may get certain hospital treatments faster during the daytime and on weekdays.

But of course, that's no reason to delay heading to the hospital.

The ideal time to have a heart attack is never. It's essential to call for emergency care immediately at the first sign of a heart attack, no matter when it happens.

Researchers working on the study included Harlan Krumholz, MD, MS, a professor at Yale University's medical school. Their report appears in The Journal of the American Medical Association.

Researcher's Advice for Patients

Krumholz shared these tips for patients:

  • Get help right away for a possible heart attack.
  • At the hospital, ask what the treatment plan is and how long it will take.
  • Speak up if you have questions or sense delay.

"Every minute counts, whether it's in the hospital or out of the hospital," says Krumholz. "This article focuses on the need for hospitals to work harder to improve systems, so that once somebody comes to the door that there's not a minute wasted. But patients need to know that every minute that's wasted before they get to the hospital also places them at greater risk.

"So, this is a call for patients to realize that if you think you have the symptoms of a heart attack don't delay at all. Go see your doctor, go to the emergency room if necessary, call 911, but don't delay because those minutes before getting to the hospital are also important. You don't want any time wasted there, either."

Rocking the Boat?

"For patients, I think it's about being persistently, yet appropriately, impatient," says Krumholz. "There's nothing wrong with ... asking politely about what the plan is."

A family member or other ally could help, says Krumholz. Hospitals may also have patient advocates. "It would be great if there were advocates waiting who were really going to try to help push the system for you, but that's not usually what's available to you," says Krumholz.

"I think the most important thing is to understand what the plan is and how quickly that plan is going to be executed," he continues. "But when you're coming in with a heart attack, you're in a very vulnerable position, and it's very hard to do that. And people are also very reluctant to rock the boat because they need the good will of the people who are taking care of them."

Thousands of Heart Attack Patients Studied

Data came from more than 100,000 heart attack patients at 421 U.S. hospitals. They needed drugs or surgery to reopen clogged arteries as part of their immediate treatment.

Not all heart attack patients need those treatments, but nearly 30% to 40% do, Krumholz tells WebMD. When needed, the sooner such treatments are done, the better a patient's chance of survival, write the researchers.

Many of the patients had delays before getting artery-opening surgery, especially during "off-hours," which were any time other than 7 a.m. to 5 p.m. on weekdays, write the researchers.

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