From Deseret News archives:

Treatments boosting odds for heart attack patients

Published: Monday, May 7, 2007 12:07 a.m. MDT
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Improved treatments over the past six years have reduced risk of heart failure or death for heart attack patients, according to a large international study released this past week.

The study, led by researchers at the University of Edinburgh in Scotland, was published in the Journal of the American Medical Association Wednesday.

Researchers found that use of medications including statins, beta-blockers, angiotensin-converting enzyme (ACE) inhibitors and other measures increased in that time period. And rates of heart failure and pulmonary edema decreased, as did stroke and death, both at the time and through six-month follow-up.

The researchers looked at data from 44,372 patients with an acute cardiac syndrome to see if changes in the way hospitals treated the patients improved the clinical outcomes. Patients were followed between July 1999 and December 2005 at 113 hospitals in 14 countries. While use of the improved measures nearly doubled by the end of the study period, rates of heart failure, second heart attacks and other bad outcomes was nearly halved.

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In 2005, 4.6 percent of the heart attack patients died in the hospital, compared with 8.4 percent in 1999. Eleven percent of heart attack patients developed heart failure in 2005, compared to nearly 20 percent in 1999. And 2 percent had subsequent heart attacks in 2005, compared to 4.8 percent in the earlier year.

Utah cardiologists say the findings confirm what they've seen in their own practices.

LDS Hospital has been tracking steadily improved outcomes for patients when clinicians take a few consistent measures, said Dr. Donald Lappe, chief of cardiology. When patients come to the hospital with a confirmed or suspected heart attack, he said, they're treated quickly, and the blood vessels that caused the heart attack are opened up to prevent heart tissue death.

Patients are also subjected to a stress test or angiogram to head off heart attack.

"We started in 1998 to make sure every patient who had a heart attack was sent home on the appropriate medications, including aspirin, cholesterol-lowering drugs and beta blockers to make the heart work more efficiently," said Lappe. ACE inhibitors are used to keep the heart from working too hard.

The improved outcomes are being experienced at hospitals around the country, not just those in the study, said Dr. Brad Burlew, section chief for general cardiology at University Hospital.

"For at least a decade, both medical and procedural approaches have been expected to make a difference in terms of outcome" for people with a heart attack or a syndrome that's likely to evolve into one, he said. The study confirms the benefits.

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