Shorter time lapse for angioplasty fails to cut patient deaths -study

A new study has put forth a startling but a sad fact that despite timely treatment, survival after having a cardiac arrest in the hospital setting was still low.

Medical experts believed that patients who delay in seeking medical attention miss out on the optimal benefits which can be derived during the first hour from symptom onset of heart attack such as discomfort or crushing chest pain that does not recede within five minutes.

Though hospital teams have been successful in cutting the wait in treating patients with emergency angioplasty, heart attacks deaths have still remained the same.

Lead study author and interventional cardiologist Daniel Menees, M.D., assistant professor of internal medicine at the University of Michigan Medical School stated, “Intuitively, we’ve all believed that the sooner we take patients to the cath lab, the shorter we make those treatment times, the better our patients will do. That’s not necessarily true.”

Analysis of data between 2005 and 2009
For the current study purposes, researchers analyzed survival rates among 100,000 heart attack admissions in 515 hospitals across the United States between 2005 and 2009.This period coincided with the quality-improvement national effort to reduce the time it takes to
treat a heart attack

It was noted that hospitals were successful in slashing the so-called door-to-balloon time, (average time patients suffering from a heart attack wait to be treated with angioplasty to get their clogged arteries opened) because of improved synchronization between hospital units and emergency workers.

The study found the average time dropped from 83 minutes in 2005-06 to 67 minutes in 2008-09 for a patient to get treatment in a catheterization lab. However, the proportion of patients who succumbed to the disease in the hospital remained relatively unchanged (starting out at 4.8% and winding up at 4.7%).

The researchers also analyzed Medicare data of 26,202 patients to assess the survival rate 30 days after their procedures. No significant change in death rates was perceived.

Menees stated, “The data suggests that efforts to reduce door-to-balloon time further may not result in lower death rates. Potential strategies to improve care may include increasing patient awareness of heart attack symptoms, reducing delays for treatment once symptoms begin, and shortening transfer time between health care facilities once a heart attack is recognized.”

The findings of the study are published in the New England Journal of Medicine.