Heart Attack Delays Still Problematic

Heart attack patients need to visit hospitals which perform angioplasty

(RxWiki News) Time is of essence during any heart attack, but fast treatment is especially critical following a type of heart attack in which there is a complete blockage of the blood supply to the heart.

There have been improvements in treating such patients with angioplasty to open blocked arteries, but delays in transferring patients on time to medical facilities that can perform the procedure are still proving to be a problem.

"Know which hospitals offer angioplasty during a heart attack."

Dr. Timothy D. Henry, senior author of the research and director of research at the Minneapolis Heart Institute Foundation at Abbott Northwestern Hospital in Minneapolis, said that delays are still occurring despite tremendous improvements in treatments to open blocked arteries.

He said this marks the first study that identifies specific reasons for the delays.

In the case of ST-segment elevation myocardial infarction (STEMI), a type of severe heart attack, a quick response is essential. But since only about 25 percent of all hospitals perform angioplasty, most most transfer them to facilities that can.

Investigators reviewed data from 2,034 STEMI patients transferred from 31 hospitals in Minnesota and Wisconsin to the Minneapolis Heart Institute from March 2003 to December 2009. Referring hospitals were up to 210 miles away.

They found that 66 percent of patients were treated within 120 minutes of arriving at the initial hospital, but the remainder experienced a delay in treatment. Of those delays, 64 percent happened at the referral hospital, while 16 percent occurred at the receiving medical facility and 13 percent were during transport to the second hospital.

Of the delays that occurred at the referral hospital, 26 percent were delayed awaiting transport, 14 percent experienced emergency room delays, 9 percent occurred because of a diagnostic dilemma, 9 percent were initially found to be negative for a heart attack and 6 percent experienced cardiac arrest that delayed their treatment.

Researchers found that delays related to cardiac arrest were most likely to result in death, and there was a reported in-hospital mortality rate of 31 percent. Some delays such as an initially negative heart attack test did not result in an increased risk of death.

Dr. Henry said that because all delays are not equal, it is important to pinpoint delays that can be improved to ensure that transferred patients receive the care that they need. He said the research indicated that the focus should be on regional systems that seek to incorporate hospitals that require patient transfer in the process.

The observational study was published in Circulation: Journal of the American Heart Association.

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Review Date: 
September 19, 2011