Good heart at­tack care could add a year to your life

Malta Independent - - HEALTH - Mar­i­lynn Mar­chione

AP Chief Med­i­cal Writer

Go­ing to the right hos­pi­tal for heart at­tack care could add a year to your life, a new study sug­gests.

Us­ing Medi­care records, re­searchers found that roughly 17 years af­ter a heart at­tack, av­er­age life ex­pectancy was 9 to 14 months longer for pa­tients who had been treated at hos­pi­tals that do best on widely used qual­ity mea­sures than for those treated at low-rated ones.

“Where you go re­ally does mat­ter,” not just for sur­viv­ing the heart at­tack but also long-term, said Dr. Emily Bu­cholz, a study leader and re­searcher at Bos­ton Chil­dren’s Hos­pi­tal.

A year of life from high-qual­ity care is a big deal; con­sider that some can­cer drugs won ap­proval for adding a few months or weeks.

But if you’re hav­ing pos­si­ble heart at­tack symp­toms, don’t de­lay get­ting help be­cause you’re wor­ried about which hos­pi­tal to go to, said an­other study leader, Yale car­di­ol­o­gist Dr. Har­lan Krumholz.

“Just call 911. Too many peo­ple wait at home too long,” and any de­lay means more risk of per­ma­nent heart dam­age, he said.

The study was funded by the Na­tional In­sti­tutes of Health. Re­sults were pub­lished Wed­nes­day by the New Eng­land Jour­nal of Medicine. Hos­pi­tals of­ten are rated based on their heart at­tack death rates at 30 days, tak­ing into ac­count how sick their pa­tients were, such as how many had di­a­betes. But it’s not known whether do­ing well in the short term trans­lates to a last­ing ben­e­fit.

The new study finds it does. Re­searchers com­pared life ex­pectancy for 120,000 Medi­care pa­tients treated be­tween 1994 and 1996 at roughly 1,800 hos­pi­tals. The dif­fer­ence in life ex­pectancy at top and low per­form­ing hos­pi­tals emerged at 30 days and re­mained over time.

“This is re­ally an im­por­tant study,” said an in­de­pen­dent ex­pert, Dr. Ralph Brindis, a Univer­sity of Cal­i­for­nia at San Fran­cisco car­di­ol­o­gist and for­mer pres­i­dent of the Amer­i­can Col­lege of Car­di­ol­ogy. “De­liv­er­ing bet­ter care not only saves lives, but that the gain per­sists over 17 years, in­de­pen­dent of how sick the pa­tients were ini­tially.”

Heart at­tack care has im­proved a lot since the 1990s, but more re­cent com­par­isons of short-term hos­pi­tal mor­tal­ity rates show that big dif­fer­ences still ex­ist.

“Where the good hos­pi­tals in your com­mu­nity are is worth know­ing,” Bu­cholz said.

And they’re not nec­es­sar­ily the ones that ad­ver­tise on TV. Medi­care has a web­site that lets you check how they do in your area and be pre­pared, es­pe­cially if you or some­one in your fam­ily is at high risk for a heart at­tack.

Heart at­tack symp­toms can be sud­den, but many start slowly, with mild pain or dis­com­fort, ac­cord­ing to the Amer­i­can Heart As­so­ci­a­tion. Signs can in­clude pres­sure, squeez­ing or pain in the chest, one or both arms, the back, neck, jaw or stom­ach; short­ness of breath; break­ing out in a cold sweat; nau­sea, or light­head­ed­ness.

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