Heart Attack Patients Face Greater Death Risk if Any Treatment Step Missed: Study

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People who’ve had a heart attack are at greater risk of death if even one of nine critical steps in their treatment is missed, according to a new study.

Researchers in the United Kingdom noted patients who missed a part of their treatment early on, such as an electrocardiogram within hours of developing symptoms, were more likely to miss other steps in their care later on. The researchers added, however, that outcomes among heart attack patients can be improved if all nine steps critical to their care are followed.

“The tragedy of all this is that these deaths are avoidable,” study leader Dr. Chris Gale, of the University of Leeds School of Medicine, said in a university news release. “There is a clear relationship between the ability to provide comprehensive and timely care, and treatment and improved chance of heart attack survival.”

The researchers identified the nine critical steps in treatment for a heart attack as:

• An electrocardiogram within a few hours after symptoms develop,
• Use of aspirin right away,
• Restoring blood flow to the heart (known as reperfusion),
• A prescription for aspirin at the time of hospital discharge,
• Timely use of four heart medications: ACE-inhibitors, beta-blockers, angiotensin receptor blockers and statins,
• Referral for cardiac rehabilitation after discharge from the hospital.

Missing one of these treatments can be fatal for those who’ve had a heart attack, according to the study, which found the chances of dying are 46 percent higher for these patients within one month of discharge from the hospital and 74 percent higher within one year.

Using one of the largest registries of quality of care and outcomes for heart attacks in England and Wales, the researchers found that about 50 percent of 31,000 heart attack patients who were discharged from the hospital between January 2007 and December 2010 did not receive all nine critical steps in their overall treatment.

Hospitals with fewer specialist beds for heart attack patients and hospitals that treated only small numbers of heart attack patients were more likely to skip a critical treatment aspect, the study’s authors noted.

The study, published in the European Heart Journal: Acute Cardiovascular Care, revealed that hospitals with no specialist cardiology beds missed care opportunities 11 percent more often than hospitals with more than 50 specialist cardiology beds.

“It is vitally important that health care professionals working in the heart disease field are made fully aware of, and trained in, these nine types of treatment so that the chances of saving a heart attack patient’s life are maximized,” Gale said. “Many of these guideline recommended steps are straightforward, but for some reason they are not being provided. If more components of care are missed, the chance of dying increases further.”

Dr. Peter Weissberg is medical director of the British Heart Foundation, the organization that funded the study. He said in the news release: “The key message is that someone’s recovery from a heart attack is not solely dependent on any single element of the care pathway. This research shows the importance of ensuring all elements of care for heart attack patients are optimally delivered.”

More information

The U.S. National Heart, Lung, and Blood Institute has more on treatment for heart attack.

Source: HealthDay

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