U.S. hospitals set mark for fast heart attack care
There’s never been a better time to be treated for a heart attack. U.S. hospitals have set a record for how quickly they open blocked arteries, averaging under one hour for the first time since these results have been tracked.
More than 93 percent of patients now have their arteries opened within the recommended 90 minutes of arrival.
“Things have definitely improved” from a decade ago, when less than half of heart attack patients were treated that fast, said Dr. Fred Masoudi, a University of Colorado cardiologist who led a recent report examining response times.
It’s based on records from about 85 percent of U.S. hospitals that do the artery procedure, angioplasty. Through a blood vessel in the groin or an arm, doctors guide a tube to the blockage causing the heart attack. They inflate a tiny balloon to flatten the clog, and leave behind a mesh tube called a stent to prop the artery open.
The sooner blood flow is restored, the less chance of permanent damage.
“It’s one of the few things in medicine where time, literally seconds, is of the essence. It’s where the phrase ‘time is muscle’ comes from,” said Dr. Ajay Kirtane, director of the lab that performs angioplasties at New York-Presbyterian/Columbia University Medical Center.
The risk of dying goes up 42 percent if care is delayed even a half-hour beyond the 90 minutes that U.S. guidelines say patients should be treated after arrival.
In 2005, this “door-to-balloon” time averaged a dismal 96 minutes, and the American College of Cardiology led a drive to get hospitals to improve. The report shows it plunged to 59 minutes in 2014.
But all that speed by the hospital won’t do much good unless patients act fast, too, and call 911 if they think they might be having a heart attack.
The warning signs:
■ Discomfort in the center of the chest lasting more than a few minutes, or that goes away and comes back. It can feel like pressure, squeezing, fullness or pain.
■ Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
■ Shortness of breath, which might include breaking out in a cold sweat, or feelings of nausea or lightheadedness.
The report shows that fewer people are getting procedures inappropriately. In 2014, about one third of angioplasties were elective, for non-emergency situations. Just over half were deemed to be done for clearly appropriate reasons.