Warning over care of heart attack patients

HEART attack patients who miss just one key element of care massively increase their chance of dying within a month of leaving hospital, according to new research.

A study by the University of Leeds found the risk of death within a month increased by 46 per cent while the risk of death within a year went up by 74 per cent.

The findings were based around nine elements of care identified as: pre-hospital electrocardiogram; acute use of aspirin; restoring blood flow to the heart (reperfusion); prescription at hospital discharge of aspirin; timely use of four types of drug for heart attack (ACE-inhibitors, beta-blockers, angiotensin receptor blockers and statins); and referral for cardiac rehabilitation after discharge from hospital.

Risks increased further for those who missed a course of treatment, such as an electrocardiogram, within the first few hours of the onset of symptoms. They were much more likely to miss other types of care later on.

Researchers looked at outcomes for heart attack patients discharged from hospital in England and Wales between January 2007 and December 2010. During that period, around half of the 31,000 heart attack patients discharged had missed a course of treatment.

Research lead Dr Chris Gale of the University of Leeds said: “The tragedy of all this is that these deaths are avoidable.

“It is vitally important that healthcare professionals working in the heart disease field are made fully aware of, and trained in, these nine types of treatment so that the chances of saving a heart attack patient’s life are maximised. Many of these guideline recommended steps are straightforward, but for some reason they are not being provided. If more components of care are missed, the chance of dying increases further.”

Professor Peter Weissberg, Medical Director at the British Heart Foundation which funded the research, said: “The key message is that someone’s recovery from a heart attack is not solely dependent on any single element of the care pathway. This research shows the importance of ensuring all elements of care for heart attack patients are optimally delivered.”

The research also showed that hospitals with fewer specialist beds for heart attack patients and hospitals that treated smaller numbers of these patients were more likely to miss opportunities to deliver care. Hospitals with no specialist cardiology beds missed care opportunities 11 per cent more often than those with more than 50 specialist cardiology beds.

The research has been published in European Heart Journal Acute Cardiovascular Care.

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