Emergency Heart Attack Access Remains Limited

Angioplasty offered at more hospitals but access has not grown proportionally

/ Author:  / Reviewed by: Joseph V. Madia, MD

(RxWiki News) A larger number of hospitals are offering an emergency artery-opening procedure following a heart attack. This may do little to help patients though, since access to care has improved very little.

Over a five-year period, there has been a 44 percent increase in the number of hospitals offering emergency care such as angioplasty to restore normal blood flow after a heart attack, but access to care has improved by only 1 percent.

"Know which local hospitals offer angioplasty if you have heart disease."

Thomas W. Concannon, Ph.D., study leader and an assistant professor at Tufts Medical Center and Tufts University School of Medicine, said that new angioplasty programs have largely failed to boost patient access or reduce treatment delays.

He said that areas hoping to increase access should instead focus on enhanced ambulance service and well-positioned programs, as opposed to the sheer number of programs. Concannon noted that such a shift in priorities could make a significant impact and help save the lives of patients.

Angioplasty is available at about one in three U.S. hospitals, and patients who are within a 60-minute drive of capable hospitals have the best chance at avoiding or reducing damage from a heart attack.

During the study researchers reviewed the 2006 American Hospital Association Annual Survey Database of all 50 states and the District of Columbia, the 2006 Health Care Cost and Utilization Project’s State Inpatient Databases from 21 states, and 2000 U.S. Census results.

Hospitals were considered to offer Percutaneous Coronary Intervention, which includes angioplasty and stent placement to prop open arteries, if they performed at least four angioplasty procedures per year on U.S. adults over the age of 18.

The number of hospital offering the procedure grew by 519 from 1,176 in 2001 to 1,695 in 2006. During the same period the number of patients with timely access to angioplasty increased from 79 percent to 79.9 percent. The small increase was not found to substantially reduce drive time among patients who already had access to the procedure. Median drive time was reduced by 48 seconds from 11.3 minutes to 10.5 minutes.

Regionally, access varied, with access highest in the northeast at 87.8 percent and the lowest in the south at 75.7 percent. Those with the highest access included residents of Washington D.C. at 100 percent, New Jersey with 96.5 percent and Rhode Island with 96.1 percent. The lowest access was available to residents of Wyoming at 35 percent, Vermont at 38 percent and Alaska at 40 percent.

The study will be published Jan. 1 in Circulation: Cardiovascular Quality and Outcomes, a journal of the American Heart Association.

Reviewed by: 
Review Date: 
December 19, 2011
Last Updated:
December 24, 2011