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Hospital Heart Attack Deaths Dropping

Researchers Say More Patients Are Getting Recommended Treatments
WebMD Health News
Reviewed by Louise Chang, MD

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 the 1990s.

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 increased.

"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, MD.

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 outcomes."

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.

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