From Our 2010 Archives
Heart Attack Care Is Getting Better, Report Finds
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MONDAY, July 12 (HealthDay News) -- Patients who have a heart attack and undergo procedures to open blocked arteries are getting proven treatments in U.S. hospitals faster and more safely than ever before, according to the results of a large-scale study.
Data on more than 131,000 heart attack patients treated at about 250 hospitals from January 2007 through June 2009 also showed that the patients themselves have become more aware of the signs of heart attack and are showing up at hospitals faster for help.
Lead researcher Dr. Matthew T. Roe, an associate professor of medicine at Duke University Medical Center and the Duke Clinical Research Institute, thinks a combination of improved treatment guidelines and the ability of hospitals to gather data on the quality of their care accounts for many of the improvements the researchers found.
"We are in an era of health care reform where we shouldn't be accepting inferior quality of care for any condition," Roe noted.
"Patients should be aware that we are trying to be on the leading edge of making rapid improvements in care and sustaining those," he added. "Patients should also be aware that the U.S. is on the leading front of cardiovascular care worldwide."
The report is published in the July 20 issue of the Journal of the American College of Cardiology.
Roe's team, using data from two large registry programs of the American College of Cardiology Foundation's National Cardiovascular Data Registry, found there were significant improvements in a number of areas in heart attack care:
In addition, patients were more aware of the signs of heart attack and the time from the onset of the attack until patients arrived at the hospital was cut from an average 1.7 hours to 1.5 hours, the researchers found.
Roe's group also found that for patients undergoing an angioplasty:
Despite all the good news, Roe's team said there was still room for improvement in care, particularly in ways to reduce the risk of bleeding that is present with even the most advanced treatments.
"We need to do ongoing and regular surveillance of care patterns" Roe said.
Dr. Gregg C. Fonarow, a cardiology professor at the University of California, Los Angeles, commented that "national clinical registries provide valuable data to characterize recent trends in the treatment and in-hospital clinical outcomes for patients hospitalized with cardiovascular disease or those undergoing cardiovascular procedures."
This new report demonstrates improvements in the speed in which reperfusion is offered in heart attack patients, better use of guideline-recommended medications in heart attack patients, and decreases in complications in patients undergoing coronary procedures, Fonarow said.
"These findings show the substantial efforts to provide physicians and hospitals with detailed feedback on performance coupled with targeted quality improvement efforts are producing measurable and meaningful benefits to cardiovascular disease patients," Fonarow added.
However, he said, there are further opportunities to improve care and clinical outcomes for patients with heart attacks and those undergoing cardiovascular procedures. Because "not all U.S. hospitals are participating in these voluntary clinical registries, there is a very important need to expand hospital participation," Fonarow noted. Fonarow is the unpaid chair of the Get With The Guidelines committee of the American College of Cardiology ACTION registry.
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SOURCES: Matthew T. Roe, M.D., M.H.S., associate professor of medicine, Duke University Medical Center and the Duke Clinical Research Institute, Durham, N.C.; Gregg C. Fonarow, M.D., professor of cardiology, University of California, Los Angeles; July 20, 2010, Journal of the American College of Cardiology