Heart Attack Care Is Getting Better, Report Finds

Patients who have a heart attack and undergo procedures to open blocked arteries are getting proven treatments in U.S. hospitals faster and more safely than ever before, according to the results of a large-scale study. The report is published in the Journal of the American College of Cardiology.

Data on more than 131,000 heart attack patients treated at about 250 hospitals from January 2007 through June 2009 also showed that the patients themselves have become more aware of the signs of heart attack and are showing up at hospitals faster for help.

Lead researcher Matthew T. Roe, MD, an associate professor of medicine at Duke University Medical Center and the Duke Clinical Research Institute, thinks a combination of improved treatment guidelines and the ability of hospitals to gather data on the quality of their care accounts for many of the improvements the researchers found.

"We are in an era of healthcare reform where we shouldn't be accepting inferior quality of care for any condition," Roe notes. "Patients should be aware that we are trying to be on the leading edge of making rapid improvements in care and sustaining those. Patients should also be aware that the U.S. is on the leading front of cardiovascular care worldwide."

Roe's team, using data from two large registry programs of the American College of Cardiology Foundation's National Cardiovascular Data Registry, found there were significant improvements in a number of areas in heart attack care:

• An increase from 90.8% to 93.8% in the use of treatments to clear blocked blood vessels.

• An increase from 64.5% to 88% in the number of patients given angioplasty within 90 min of arriving at the hospital.

• An improvement from 89.6% to 92.3% in performance scores that measure timeliness and appropriateness of therapy.

• Better prescribing of blood thinners.

• A significant drop in hospital death rates among heart patients.

• Improvement in prescribing necessary medications, including aspirin, antiplatelet drugs, statins, beta blockers, angiotensin-converting enzyme inhibitors, and angiotensin-receptor blockers.

• Improvement in counseling patients to quit smoking and referring patients to cardiac rehabilitation.

In addition, patients were more aware of the signs of heart attack and the time from the onset of the attack until patients arrived at the hospital was cut from an average 1.7 hours to 1.5 hours, the researchers found.

Despite all the good news, Roe's team says there was still room for improvement in care, particularly in ways to reduce the risk of bleeding that is present with even the most advanced treatments.

"We need to do ongoing and regular surveillance of care patterns" Roe says.

Source: Brigham and Women's Hospital