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    Heart Attack Treatment May Lag in Off-Hours

    Study Shows Some Treatments Given Faster During Daytime, Weekdays

    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.

    Why the Delay?

    The delays that do occur ... tend to be leaking of minutes in all sorts of different directions. It's not like there's one place where all the time is spent," says Krumholz.

    "It's just that people aren't moving as quickly, and the systems aren't in place, and there may be some indecision about who's responsible. Issues can even have to do with who's transporting the patient ... how the drugs are being ordered or whether or not the laboratory is prepared. So mostly, this is something that hospitals need to get straight but for patients, I think they need to know that every minute counts."

    Hospital Guarantee?

    "The best thing that would happen is that hospitals would guarantee their communities, "You come in here with a heart attack [and] we guarantee you'll be treated within the guideline recommendations. That's what I'd like to see," says Krumholz.

    "We're showing that a large percentage of patients even during the regular period aren't being treated within the recommended guideline times. In fact, fewer than half are being treated in regular hours during the guideline time. So this is an issue that pervades the hospital at all times and it's an opportunity for us to do better, in terms of treatment. We really should be having rapid response teams, where everyone has a clear role and that the systems are in place so that everyone gets treated rapidly," he says.

    The findings might not apply to all U.S. hospitals, since the hospitals in the study voluntarily participated in a national database. "The very best hospitals have worked this out," says Krumholz.

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