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Integrated system, rapid transfer is lifeline for heart attack victims

Armen Hareyan's picture

Heart attack patients received lifesaving treatment quickly when hospitals and communities used an integrated, rapid transfer system to get patients to a facility equipped to perform artery-opening procedures, according to a report in Circulation: Journal of the American Heart Association.

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"Our aim was to develop a standardized system of heart attack care, which included timely access to artery-opening treatment for patents presenting to either the major hospital with a cardiac catheterization lab or to any one of 30 community hospitals without a cath lab," said Timothy D. Henry, M.D., lead author of the report and a cardiologist at Abbott Northwestern Hospital in Minneapolis, Minn. Abbott Northwestern Hospital is a 619-bed hospital with a cardiac catheterization lab equipped to treat heart attack patients with the artery-opening procedure called percutaneous coronary intervention (PCI), also known as angioplasty. A major heart attack is when a complete blockage occurs in a coronary artery. This is called an ST-elevation myocardial infarction (STEMI). Doctors treat STEMI patients with either emergency angioplasty or by injecting a clot-busting drug. The time between hospital arrival and treatment is called door-to-balloon time with angioplasty or door-to-needle time with drugs. A shorter door-to-treatment time with either angioplasty or a clot-busting drug increases a patient's chance of survival.

American Heart Association guidelines recommend a door-to-balloon time within 90 minutes and door-to-needle time within 30 minutes. "Angioplasty is preferred over clot-busting drugs for STEMI patients when it can be performed in a timely manner by experienced clinicians," Henry said. "However, angioplasty isn't universally available