Hospital Heart Attack Deaths Dropping
Researchers Say More Patients Are Getting Recommended Treatments
May 1, 2007 -- Heart attack-related deaths following hospital admission have
declined dramatically over the past six years, thanks to new medical treatments
and better utilization of old ones.
That is the finding from a landmark study involving 44,372 heart attack
patients or patients with severe heart-related chest pain treated at 113
hospitals in 14 countries.
In-hospital heart attack death rates dropped by almost half, from 8.4%
during the last six months of 1999 to 4.6% during the same period in 2005,
among patients admitted to hospitals with severe heart attacks involving
complete artery blockage.
Heart failure rates also declined during the period, and outcomes six months
after the heart attack also greatly improved. Heart failure refers to a heart
with weakened pumping strength.
The findings prove that treatment guidelines are making a difference in
heart attack outcomes at the population level, University of Edinburgh
professor of cardiology Keith A. Fox, MBChB, tells WebMD.
"This is really a call to action to hospitals not meeting the standards
of reasonable treatment," Fox says. "We know these treatments work.
They save lives."
More Aggressive Treatment
Writing in the May 2 issue of TheJournal of the American Medical
Association, Fox and colleagues confirmed major increases in cardiac
catheterization and the utilization of heart- protecting drugs since the end of
Between mid-1999 and December 2005, the use of angioplasty to reopen blocked
arteries increased by more than 30% in patients with complete blockages and 20%
among patients with partial blockages.
During the same period, the use of aspirin, cholesterol-lowering statins,
clot-busting drugs, beta-blockers, ACE inhibitors, and blood thinners also
"Hospitals and physicians are doing a better job through the hospital
stay, from admission to discharge, of using these evidence-based treatments
that have been shown to be of benefit," says researcher Kim A. Eagle,
But there is still plenty of room for improvement, especially in the U.S.,
which has been shown in some studies to lag behind parts of Europe in certain
aspects of heart attack care.
Many patients who could benefit from the most aggressive treatments still
aren't getting them, Eagle says.
Eagle -- the director of the cardiovascular center at the University of
Michigan -- notes that just over half of the heart attack patients with full
artery blockage in the study (53%) received emergency angioplasty and just 85%
received a statin in 2006.
Getting to a Hospital Quickly
How do you improve your chances of surviving a major or minor heart attack?
Learn all you can about what treatments to expect and make sure you are getting
every treatment that is appropriate for you, Eagle says.
"Heart attacks happen one patient at a time. This study suggests that
internationally we are doing a better job of treating patients. But the more
knowledgeable a patient is, the more likely we are to achieve the best
All agree that getting to a hospital quickly can mean the difference between
life and death. Studies suggest that the average time between symptom onset and
hospital arrival is between 90 minutes and two hours.
"Many people delay seeking treatment because they think it isn't
happening to them or it is a false alarm," Northwestern Memorial Hospital
chief of cardiology Robert Bonow, MD, tells WebMD.
Bonow, who is a past president of the American Heart Association, says it is
clear hospitals are doing a better job of implementing guidelines, but he adds
that there is still plenty of room for improvement.
"We have a long way to go to make this higher-quality care available for
every heart attack patient," he says.