Hospital Care of Heart Attack Patients Has Improved

Safe, timely administration of care such as PCI has increased; mortality has fallen
By Monica Smith
HealthDay Reporter

TUESDAY, July 13 (HealthDay News) -- Hospitals nationwide have improved their care of heart attack patients and are increasingly administering therapies -- such as percutaneous coronary intervention (PCI) -- in a timely manner, safely, and according to clinical guidelines, according to a new analysis of data from the American College of Cardiology's National Cardiovascular Data Registry published in the July 20 issue of the Journal of the American College of Cardiology.

Matthew T. Roe, M.D., of Duke University Medical Center in Durham, N.C., and colleagues analyzed data on 131,980 heart attack patients treated at approximately 250 centers from January 2007 to June 2009, to look for outcomes and trends in care for these patients.

The researchers found improvements in treatment for ST-segment elevation myocardial infarction (STEMI) patients, including an increase from 90.8 to 93.8 percent in use of treatments that restore blood flow to the heart, and an increase from 64.5 to 88 percent in proportion of patients treated with PCI within 90 minutes of arriving at the hospital. There were also improvements in timeliness and appropriate therapy performance scores of therapy for STEMI patients, in dosing non-STEMI patients properly with blood thinners, and in adhering to prescribing guidelines for medications. Risk-adjusted hospital death rates fell from 6.2 to 5.5 percent in STEMI patients, and from 4.3 to 3.9 percent in non-STEMI patients.

"The contemporary profile of care patterns for patients with acute myocardial infarction and those undergoing PCI indicates that patient and procedural characteristics have changed over a relatively short time, while significant improvements in the receipt and timeliness of reperfusion therapy for STEMI, in the overdosing of antithrombotic therapies, in the safety and results of PCI procedures, and in composite measures of acute myocardial infarction care were also demonstrated," the authors write.

Several authors disclosed relationships with medical technology and pharmaceutical companies.

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