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Senior Citizen Health & Medicine
Getting to Hospital Fast Improves Heart Attack
Chances 70 Percent
Mayo Clinic researchers emphasize calling 911
immediately
 Nov. 5, 2007 - If you go to the hospital within one
to two hours of the onset of symptoms of a heart attack, your chances of
getting proper treatment are nearly 70 percent greater than those who
wait 11 to 12 hours before seeking treatment, according to results
presented today at the American Heart Association’s Scientific Sessions
2007 in Orlando, Fla.
“This research should emphasize to patients that
getting help immediately, by calling 911, gives them the best chance of
receiving treatments we know can help save their lives or lessen the
damage to their hearts,” says Henry Ting, M.D., lead Mayo Clinic
cardiovascular researcher on the national study.
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“If patients wait at home for hours with symptoms
and come in later, unfortunately they aren’t getting the proper
treatments.”
The most serious type of heart attack is known as
an ST-elevation myocardial infarction (STEMI). In a STEMI, critical
arteries supplying the heart with blood are blocked.
Previous studies have shown that the best treatment
for STEMI patients is reperfusion therapy -- when a patient’s
blocked artery is opened by inflating a balloon at the site of the
blockage or by delivering clot-dissolving medication, thus restoring
blood flow to heart muscle.
Significance of Study
The study is the largest and most detailed review
of multiple elements in patient records contained in a national heart
attack database.
These elements are:
● time delay from onset of symptoms to hospital arrival;
● treatment with reperfusion; and
● treatment outcome.
After analyzing 440,398 heart attack incidents from
1995 to 2004 in the National Registry of Myocardial Infarction, the
researchers identify for the first time a novel risk factor for heart
attack deaths that appears to have a readily available solution: comply
with the American Heart Association/American Cardiology Association
guidelines now in place.
The guidelines state that if a patient has
symptoms consistent with a heart attack which are not relieved after
five minutes, or after placing one nitroglycerin pill under the tongue,
the patient should call 911.
About the Study
The records that the team reviewed document how
long it took for 440,398 heart attack patients to arrive at the hospital
after their symptoms started, and correlate arrival time with the rates
of reperfusion therapy they received upon arriving at the hospital.
Results show that:
● Of patients who arrived at the hospital within
one to two hours of onset of heart attack, 77 percent received
reperfusion therapy.
● Of patients who arrived at the hospital within
two to three hours of onset of heart attack, 73 percent received
reperfusion therapy.
● Of patients who arrived at the hospital within
11 to 12 hours of onset of heart attack, only 46 percent of patients
received reperfusion therapy.
“Although current guidelines recommend that STEMI
patients who reach the hospital within 12 hours after their symptoms
started should receive reperfusion therapy, we found that this is not
happening,” Dr. Ting says.
“These delays represent a novel and modifiable risk
factor and warrant further investigation. These results show that gaps
remain in quality of care in patients with STEMI -- first, we need to
encourage patients with potential heart attacks to come to the hospital
as early as possible; second, hospitals need to implement systems that
treat all eligible patients rapidly regardless of the delay in
presentation.”
Editor’s Notes:
Co-authors of the study are Bernard Gersh, M.B.Ch.B.,
D.Phil., and Veronique Roger, M.D., M.P.H., both of Mayo Clinic; Harlan
Krumholz, M.D., and Jeptha Curtis, M.D., both of Yale University;
Elizabeth Bradley, Ph.D., Yongfei Wang and Judith Lichtman, Ph.D., all
of Yale School of Public Health; and Brahmajee Nallamothu, M.D., M.P.H.,
of University of Michigan Hospitals.
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