When Burlew started out as a cardiologist, he said heart attack patients died in large numbers. "Now, what I see is it is the exception almost that someone who had a heart attack that is promptly and properly treated will die. If someone delays too long, however, there's nothing we can do about it."

He said small hospitals have learned things they can do to improve outcome until the patient can be taken to a facility with the capability to do "definitive procedures."

Among the changes cited by the study and noted by local doctors are use of powerful drugs that slow down the clotting process, statins, clot busters, ACE inhibitors and others. Procedurally, angioplasties and stents "make a world of difference," in spite of a just-out report that says angioplasty is overused in people not having a heart attack.

"We knew that," Burlew said, "but it makes the chest pain that's bothering that patient go away. And when someone's having a heart attack, there's no question these interventional techniques save lives and heart muscle."

Teaching people everywhere the symptoms of heart attack has been an ongoing struggle, Burlew said, but progress is being made.

The other important component, Lappe said, is making people understand that their heart attacks are as much or more a result of their diets and lifestyle — such as smoking, inactivity and obesity — as they are of genetics.

The study was funded by a grant from Sanofi, which makes several heart drugs, including ACE inhibitors. Several of the authors reported getting fees and grants from Sanofi and other drugmakers. -->

---

E-mail: lois@desnews.com