Many MISSING OUT on lifesaving heart attack treatment

A TEN year study of 300,000 heart attack patients has found rapid rates in the uptake of a treatment which improves a patient’s chances of survival.

 

The rapid uptake of the emergency stenting treatment (PPCI) gives 9 in 10 patients survival chance

 

In particular, the rapid uptake of the emergency stenting treatment (PPCI) gives nine in 10 patients fighting chance of survival.

Despite discovering this treatment could save thousands of lives, the researchers argue there are huge disparities in who receives the treatment.

The research - part funded by the British Heart Foundation (BHF) and led by the University of Leeds - showed the use of emergency PPCI increased from 0.1 per cent in 2003 to 86 per cent in 2013 for patients with STEMI.

This is a heart attack caused by a complete blockage of a coronary artery which accounts for 25 to 40 per cent of all heart attack cases in Europe.

Recipients of the procedure are over a THIRD less likely to die compared to those treated with clot busting drugs.

 

Patients are over a THIRD less likely to die compared to those treated with clot busting drugs.

 

The BHF says all patients having a STEMI should be taken to a designated heart attack centre with the facilities and staff to deliver round the clock PPCI, seven days a week. 

PPCI involves opening a blocked artery to restore blood flow to the oxygen-starved part of the heart and has helped save thousands of lives since becoming available in the early 2000’s. 

The introduction of PPCI followed a ten-year action plan for heart disease (National Service Framework for Coronary Heart Disease) and prompted system-wide change and led to an increase in the number of hospitals able to deliver this lifesaving treatment.

However the research, published in the journal Heart, also found vast differences in the provision of PPCI treatment between hospitals, ranging from a four - 300 per cent increase over the ten years. 

Patients suffering from diabetes, angina or having previously had a heart attack were less likely to receive the treatment, with chronic illness increasing the difficultly of diagnosis.

 

The treatment could save thousands of lives if implemented early

 

Living more than 30 kilometres from a hospital also lead to lower PPCI rates, but guidelines state that patients whose treatment with PPCI cannot be provided within two hours of arrival of the emergency services should receive clot busting drugs as an alternative. 

And to ensure people do not miss out on the best available treatment, the emergency services need to improve their ability to identify heart attacks in patients who are chronically ill with multiple symptoms.

To save lives, researchers believe all heart attack centres should have the facilities and infrastructure to be able to deliver this routine treatment round the clock. 

Professor Peter Weissberg, Medical Director of the BHF, said: “BHF-funded researchers first showed that a heart attack is caused by a blood clot blocking a coronary artery and that the sooner the blockage is opened, the greater the chances of survival.

“It is a testament to the NHS and its investment through the National Service Framework for Coronary Heart Disease that today nine in ten people who suffer a major heart attack in the UK are treated by PPCI. But clearly we need to do even better to guarantee all patients across the UK receive the best possible treatment.

 

There are disparities between people who receive the rapid treatment, the study warns

 

“We need to ensure that the NHS provides enough, sufficiently resourced heart attack centres providing round the clock PPCI, to avoid needless loss of life.”

The American Heart Association recently urged that patients suffering from ST-segment elevation myocardial (STEMI) should be treated within 90-minutes or less of reaching hospital.

Researchers looked at the outcomes of over 2,000 patients who had been treated within two hours and less, between two and four hours, as well as more than four hours.

The study also warned there are far better outcomes for patients treated within a two hour window.