New Treatments Help Cut Hospital Heart Attack Deaths By 50 per Cent

Twenty years ago the idea of using tiny balloons to inflate blood vessels as a treatment for heart attack may have seemed pure science fiction.

But research now shows that along with a combination of better care and new drugs, such procedures have led to heart attack deaths after reaching hospital being halved.

A unique study of almost 45,000 patients in 14 countries, conducted by Edinburgh University, has found that in the last six years survival among heart patients has vastly improved.

Professor Keith Fox, who led the study, said death rates could drop further as treatments improved and all hospitals adopted standard treatment for patients with heart attack and angina.

One of the major advances has been a procedure called angioplasty, which first became widely used in the 1980s.

A balloon-tipped tube is inserted into the blood vessel that is causing the heart problems. As it is inflated, the blockage is cleared and blood flow is improved.

Surgeons can then insert a stent – a small device to keep the vessel open and prevent further heart problems.

Patients are often also treated with anti-clotting drugs, statins and beta-blockers to stop further heart problems.

The latest study found that these combination treatments had led to plummeting death rates between 1999 and 2006 in countries including Britain, the United States, France, Spain and Germany.

Worldwide, the researchers found that among patients admitted with a severe heart attack, where arteries were completely blocked, death rates dropped from 8.4 per cent to 4.5 per cent.

The risk of heart failure – a chronic condition requiring specialised long-term care – also dropped from 20 to 11 per cent.

This means that for every 1,000 patients going to hospital, there are now 39 fewer deaths and 90 fewer patients with heart failure. The patients also saw subsequent rates of critical heart failure – known as cardiogenic shock – drop from 7.1 per cent to 4.7 per cent.

The researchers, writing in the Journal of the Medical Association, said this was vital, as 70 per cent of patients with cardiogenic shock died. “We know that advances in medical treatments have improved outcomes due to large scale trials of therapies,” Prof Fox said.

“Our study supports the fact that hospitals are using new treatments effectively.

“Patients now have a much reduced risk of dying or having another stroke while being treated in hospital and are also less likely to suffer a stroke or further heart attack once they are discharged.”

Among those with severe heart attacks, the study found the risk of having a stroke fell from 1.3 to 0.5 per cent, while further heart attacks more than halved from 4.8 per cent to 2 per cent over six years.

In the case of milder heart attacks, the risk of stroke dropped from 1.26 to 0.67 per cent, and further heart attacks fell from 3 per cent to 1.9 per cent.

Barbara Harpham, national director of charity Heart Research UK, said: “It is great that these advances in medical treatment are having such a positive effect on the outcomes of patients.

“We spend millions on medical research each year, but we realise that people have to change their lifestyle as well to reduce their risk.”

David Clark, from Chest, Heart and Stroke Scotland, welcomed the news.

He said: “This is an example of how treatment has improved over recent years and this is having a real effect on patients’ quality of life.

“However, coronary heart disease is still one of Scotland’s major killers and we still need more funding to be put into research and services for patients.”~

SPEED OF THE ESSENCE IN SAVING LIVES

WHEN Brian Davie started suffering serious chest pains on Sunday night, he feared the worst.

The 56-year-old called 999 and within five minutes, an ambulance had arrived to take him to Edinburgh Royal Infirmary, along with his wife, Linda.

Less than two hours later he was in bed recovering, after having angioplasty to clear the blockage in his blood vessels which led to his heart attack.

“I couldn’t believe how quickly it all happened,” Mr Davie said.

“The ambulance crew were doing an ECG [electrocardiogram] while I was on my sofa at home and they sent it through to the hospital.

“Then when we arrived I was whisked through, they gave me drugs for the pain and then I was having this balloon inserted on a tube from my groin up to my heart.”

Mr Davie said his treatment had been “fantastic” and praised all the ERI staff.

He is now on anti-clotting drugs and beta-blockers and should be out of hospital in the next couple of days and back to work within a few weeks.

“The care I have received has just been amazing. I really thought I was not going to make it when the pain got so bad,” said Mr Davie, from Musselburgh.