Antman suggests that heart disease patients ask their doctor if there is a hospital nearby that does angioplasty around the clock. If so, they might want to discuss with their doctor whether to ask that an ambulance take them there if they are having a heart attack.

Antman said, if it is feasible to get to an angioplasty-providing hospital within an hour, "in most cases that would be preferable."

Proper therapy

Opening an artery is only the start of treatment. The next part is at least as problematic: Patients have to get the right drugs, in the right doses, and have to take them for the rest of their lives.

"Care is getting a lot better," Peterson said. "But the only caveat is that they are only really looking at, Did you get therapy? No one is looking too closely at, Did you do it right?"

For example, he said, a recent study found that heart attack patients were getting blood-thinning prescription drugs to prevent clots, as they should, but up to 40 percent were getting the wrong dose, usually one too high.

And even if every prescription were exactly right, as many as half of all patients stop taking many or all of their drugs.

Sometimes it is a matter of communication.

"The information did not get to the primary doctor and the primary doctor did not know to renew the prescription," Peterson said. "When we talk to patients, they say: 'No one communicated to me the importance of being on the medications long term. I thought I would only need them for three months, I thought it would be like an antibiotic. I thought they put in a stent so why do I need a drug?"'

But there may be more to it than ignorance: The image those pills — even taking an aspirin every day — convey being a sick person. But taking aspirin makes blood less likely to clot.

Antman has a message for patients: With a disease as serious as heart disease, those who take responsibility are often the ones who survive.