Which Hospital Offers the Best Heart Treatment?

Percutaneous coronary intervention equipped hospitals treat heart attacks quicker

(RxWiki News) Heart attack patients immediately rushed to hospitals capable of using a balloon catheter to clear blocked arteries are more likely to receive treatment sooner.

Patients received treatment an average of 31 minutes faster if they were taken to a hospital equipped to perform percutaneous coronary intervention (PCI), or angioplasty to open clogged arteries.

"Consider requesting a PCI capable hospital if you suspect a heart attack."

Emil L. Fosbol, MD, PhD, the study’s first author and a research fellow at Duke University, said the study marked the first to exam recommendations that emergency medical service personnel transport patients that have suffered ST-elevation myocardial infarction (STEMI), a serious type of heart attack that involves complete blockage of blood flow to the heart, to PCI capable hospitals, potentially passing others that are not equipped to perform PCI.

Prior to the study Dr. Fosbol said: "The only rationale we had was the sooner you get there, the better.”

During the study investigators reviewed North Carolina's EMS records from June 2008 through September 2010, linking cases to a clinical registry of STEMI patients. Of 1,224 STEMI patients, 63 percent of patients bypassed other medical facilities and were taken directly to a PCI-capable hospital, while 37 percent first stopped at a hospital without PCI capabilities. Patients from the second group were then transferred for the PCI procedure.

Researchers found that the time from first medical contact to PCI or clot-busting drugs to open the arteries averaged 93 minutes for the bypass group compared to 124 minutes for the other group, a substantial time difference that could impact patient survival. Among patients that only received PCI, the bypass group averaged 93 minutes versus 161 minutes in the non-bypass group.

Investigators also noted that STEMI patients in the bypass group were three times more likely to receive treatment within the guideline recommendations and less likely to die in the hospital.

“PCI is contingent on getting the patient very quickly to a hospital with a catheter lab,” Dr. Fosbol said. “Our results suggest that when logistically feasible, EMS should transfer STEMI patients directly to the nearest PCI-capable hospital.”

The research, funded by the American Heart Association-Pharmaceutical Roundtable and David and Stevie Spina, was presented Thursday at the American Heart Association’s Quality of Care and Outcomes Research 2012 Scientific Sessions in Atlanta, Georgia.

Review Date: 
May 8, 2012