Integrated system, rapid transfer is lifeline for heart attack victims

Armen Hareyan's picture
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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

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